[NHA PHLEBOTOMY EXAM] – EXAM-STYLE QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED
PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A phlebotomy technician is preparing to perform a venipuncture on a patient
who reports a history of fainting during previous blood draws. Which of the
following actions should the technician take first?
A. Position the patient in a supine position.
B. Apply a cold compress to the patient's forehead.
C. Instruct the patient to take deep, rapid breaths.
D. Proceed with the draw while reassuring the patient.
Correct Answer: A. Position the patient in a supine position.
Rationale: Placing the patient in a supine or Trendelenburg position is the primary
intervention to prevent injury from syncope and to promote cerebral blood flow.
This proactive measure is prioritized over symptomatic treatments like cold
compresses. Rapid breathing can lead to hyperventilation and is not recommended.
Proceeding without a position change is unsafe given the patient's history.
2. According to CLSI standards, which of the following is the correct order of
draw for a routine venipuncture using a syringe and transfer device?
A. Light blue, red, green, lavender, gray
B. Red, light blue, green, lavender, gray
C. Light blue, green, red, lavender, gray
D. Red, green, light blue, lavender, gray
Correct Answer: A. Light blue, red, green, lavender, gray
,Rationale: The CLSI-recommended order of draw is designed to minimize cross-
contamination of additives between tubes. The correct sequence is blood culture
bottles (when applicable), sodium citrate (light blue), serum tubes without additive
(red) or with clot activator (gold), heparin (green), EDTA (lavender), and glycolytic
inhibitor (gray). The other sequences violate this standard, potentially leading to
erroneous test results due to carryover of additives.
3. A phlebotomist collects a specimen for a prothrombin time (PT) test. Which
of the following tubes is appropriate for this collection?
A. Tube containing sodium heparin.
B. Tube containing potassium oxalate.
C. Tube containing sodium citrate.
D. Tube containing ethylenediaminetetraacetic acid (EDTA).
Correct Answer: C. Tube containing sodium citrate.
Rationale: Prothrombin time testing evaluates the extrinsic pathway of coagulation
and requires plasma. Sodium citrate is the only appropriate anticoagulant for
coagulation studies, as it binds calcium and preserves the coagulation factors.
Heparin interferes with the test, oxalate is used for glucose, and EDTA is used for
hematology studies and will sequester calcium, making coagulation testing invalid.
4. A phlebotomy technician must collect a blood culture specimen. Which of
the following is the most critical step to prevent contamination of the sample?
A. Using a 23-gauge needle for collection.
B. Cleansing the site with 70% isopropyl alcohol.
C. Cleansing the site with chlorhexidine gluconate and allowing it to dry
,completely.
D. Tying the tourniquet tightly to visualize the vein.
Correct Answer: C. Cleansing the site with chlorhexidine gluconate and allowing
it to dry completely.
Rationale: The most critical step in collecting blood cultures is proper skin antisepsis
to eliminate skin flora and prevent false-positive results. Chlorhexidine gluconate is
a preferred agent for this purpose. The antiseptic must be allowed to dry completely
to ensure adequate kill time. Alcohol alone is not sufficient for cultures. Needle
gauge and tourniquet application are less critical to preventing contamination.
5. Upon entering a patient's room, a phlebotomy technician notices a sign
indicating the patient is on "contact precautions." Which of the following
personal protective equipment (PPE) is essential for the technician to don
before performing the venipuncture?
A. N95 respirator and face shield.
B. Gown and gloves.
C. Gloves and surgical mask.
D. Gown, gloves, and eye protection.
Correct Answer: B. Gown and gloves.
Rationale: Contact precautions are implemented for patients with infections
transmitted by direct or indirect contact. The essential PPE includes a gown and
gloves. An N95 respirator is for airborne precautions, while a surgical mask and eye
protection are typically for droplet precautions or standard precautions during
procedures with splash risk.
, 6. A phlebotomist is preparing to perform a dermal puncture on a 6-month-old
infant. Which of the following sites is most appropriate for this procedure?
A. The heel, on the medial or lateral plantar surface.
B. The center of the heel.
C. The palmar surface of the distal finger.
D. The plantar surface of the great toe.
Correct Answer: A. The heel, on the medial or lateral plantar surface.
Rationale: For infants under one year of age, the heel is the recommended site for
capillary puncture. The puncture should be performed on the medial or lateral
plantar surfaces to avoid the calcaneus (heel bone) and reduce the risk of
osteomyelitis. The center of the heel must be avoided. Fingers are not used for
infants due to their small size and risk of bone injury.
7. A blood specimen for a complete blood count (CBC) was collected in a
lavender-top tube. The specimen is visibly hemolyzed. Which of the following
factors is the most likely cause of this hemolysis?
A. Insufficient inversion of the tube.
B. Use of a 21-gauge needle.
C. Excessive force used to transfer blood into the tube.
D. The tube was not filled to the proper volume.
Correct Answer: C. Excessive force used to transfer blood into the tube.
Rationale: Hemolysis is the rupture of red blood cells. Excessive force, such as
forcing blood through a small needle into a tube or expelling blood from a syringe
too rapidly, creates shear stress that damages cells. Insufficient inversion can cause
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED
PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A phlebotomy technician is preparing to perform a venipuncture on a patient
who reports a history of fainting during previous blood draws. Which of the
following actions should the technician take first?
A. Position the patient in a supine position.
B. Apply a cold compress to the patient's forehead.
C. Instruct the patient to take deep, rapid breaths.
D. Proceed with the draw while reassuring the patient.
Correct Answer: A. Position the patient in a supine position.
Rationale: Placing the patient in a supine or Trendelenburg position is the primary
intervention to prevent injury from syncope and to promote cerebral blood flow.
This proactive measure is prioritized over symptomatic treatments like cold
compresses. Rapid breathing can lead to hyperventilation and is not recommended.
Proceeding without a position change is unsafe given the patient's history.
2. According to CLSI standards, which of the following is the correct order of
draw for a routine venipuncture using a syringe and transfer device?
A. Light blue, red, green, lavender, gray
B. Red, light blue, green, lavender, gray
C. Light blue, green, red, lavender, gray
D. Red, green, light blue, lavender, gray
Correct Answer: A. Light blue, red, green, lavender, gray
,Rationale: The CLSI-recommended order of draw is designed to minimize cross-
contamination of additives between tubes. The correct sequence is blood culture
bottles (when applicable), sodium citrate (light blue), serum tubes without additive
(red) or with clot activator (gold), heparin (green), EDTA (lavender), and glycolytic
inhibitor (gray). The other sequences violate this standard, potentially leading to
erroneous test results due to carryover of additives.
3. A phlebotomist collects a specimen for a prothrombin time (PT) test. Which
of the following tubes is appropriate for this collection?
A. Tube containing sodium heparin.
B. Tube containing potassium oxalate.
C. Tube containing sodium citrate.
D. Tube containing ethylenediaminetetraacetic acid (EDTA).
Correct Answer: C. Tube containing sodium citrate.
Rationale: Prothrombin time testing evaluates the extrinsic pathway of coagulation
and requires plasma. Sodium citrate is the only appropriate anticoagulant for
coagulation studies, as it binds calcium and preserves the coagulation factors.
Heparin interferes with the test, oxalate is used for glucose, and EDTA is used for
hematology studies and will sequester calcium, making coagulation testing invalid.
4. A phlebotomy technician must collect a blood culture specimen. Which of
the following is the most critical step to prevent contamination of the sample?
A. Using a 23-gauge needle for collection.
B. Cleansing the site with 70% isopropyl alcohol.
C. Cleansing the site with chlorhexidine gluconate and allowing it to dry
,completely.
D. Tying the tourniquet tightly to visualize the vein.
Correct Answer: C. Cleansing the site with chlorhexidine gluconate and allowing
it to dry completely.
Rationale: The most critical step in collecting blood cultures is proper skin antisepsis
to eliminate skin flora and prevent false-positive results. Chlorhexidine gluconate is
a preferred agent for this purpose. The antiseptic must be allowed to dry completely
to ensure adequate kill time. Alcohol alone is not sufficient for cultures. Needle
gauge and tourniquet application are less critical to preventing contamination.
5. Upon entering a patient's room, a phlebotomy technician notices a sign
indicating the patient is on "contact precautions." Which of the following
personal protective equipment (PPE) is essential for the technician to don
before performing the venipuncture?
A. N95 respirator and face shield.
B. Gown and gloves.
C. Gloves and surgical mask.
D. Gown, gloves, and eye protection.
Correct Answer: B. Gown and gloves.
Rationale: Contact precautions are implemented for patients with infections
transmitted by direct or indirect contact. The essential PPE includes a gown and
gloves. An N95 respirator is for airborne precautions, while a surgical mask and eye
protection are typically for droplet precautions or standard precautions during
procedures with splash risk.
, 6. A phlebotomist is preparing to perform a dermal puncture on a 6-month-old
infant. Which of the following sites is most appropriate for this procedure?
A. The heel, on the medial or lateral plantar surface.
B. The center of the heel.
C. The palmar surface of the distal finger.
D. The plantar surface of the great toe.
Correct Answer: A. The heel, on the medial or lateral plantar surface.
Rationale: For infants under one year of age, the heel is the recommended site for
capillary puncture. The puncture should be performed on the medial or lateral
plantar surfaces to avoid the calcaneus (heel bone) and reduce the risk of
osteomyelitis. The center of the heel must be avoided. Fingers are not used for
infants due to their small size and risk of bone injury.
7. A blood specimen for a complete blood count (CBC) was collected in a
lavender-top tube. The specimen is visibly hemolyzed. Which of the following
factors is the most likely cause of this hemolysis?
A. Insufficient inversion of the tube.
B. Use of a 21-gauge needle.
C. Excessive force used to transfer blood into the tube.
D. The tube was not filled to the proper volume.
Correct Answer: C. Excessive force used to transfer blood into the tube.
Rationale: Hemolysis is the rupture of red blood cells. Excessive force, such as
forcing blood through a small needle into a tube or expelling blood from a syringe
too rapidly, creates shear stress that damages cells. Insufficient inversion can cause
