PHLEBOTOMY NPCE EXAM A+
2026/2027
National Phlebotomy Certification Examination • Official-Style Practice Assessment
A+ QUESTIONS VERIFIED 5 CONTENT SECTIONS 100% RATIONALES
CATEGORIES
■ 1. Safety, Infection Control & Compliance
■ 2. Patient Identification, Communication & Preparation
■ 3. Venipuncture & Capillary Collection Techniques
■ 4. Equipment, Order of Draw & Specimen Handling
■ 5. Special Collections, Complications & Quality Assurance
Exam Format: Multiple-choice (A–D) • 1 mark each • Passing score 75%
Cognitive Level: Application & Analysis • Scenario-based items
Time Recommendation: 2 hours • Professional Certification Standard
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Original content aligned to public NPCE / national phlebotomy certification blueprints
, SECTION 1: Safety, Infection Control & Compliance
Q1. A phlebotomist is preparing to draw blood from a patient diagnosed with active tuberculosis. The isolation sign on
the door indicates airborne precautions. After donning a gown and gloves, the phlebotomist reaches for a standard
surgical mask. Which action correctly completes the PPE sequence for this patient?
A. Replace the surgical mask with an N95 respirator before entering the room
B. Proceed with the surgical mask because gloves and gown already provide adequate protection
C. Add a face shield only if the patient is coughing during the draw
D. Use a surgical mask and request the nurse to remain present during the procedure
Correct Answer: A
Rationale: Airborne precautions for tuberculosis require an N95 respirator or higher-level respirator. A surgical mask does not
filter airborne droplet nuclei. The correct sequence is to don the appropriate respirator before entering the isolation room.
Q2. While performing a routine venipuncture, a phlebotomist accidentally sustains a needlestick injury after the needle
is withdrawn. The patient is known to be hepatitis B surface antigen positive. What is the first immediate action the
phlebotomist must take?
A. Squeeze the wound to force blood out and then apply alcohol
B. Report the incident to the supervisor before any first aid
C. Apply a tourniquet proximal to the injury to limit spread
D. Wash the puncture site thoroughly with soap and water
Correct Answer: D
Rationale: Immediate first aid for a needlestick is thorough washing of the site with soap and water. Squeezing or applying
tourniquets is not recommended. Reporting occurs after initial first aid, followed by post-exposure evaluation.
Q3. A laboratory manager is reviewing the facility's exposure control plan. Which element must be included to remain
compliant with the OSHA Bloodborne Pathogens Standard?
A. Mandatory HIV testing of all patients prior to any blood collection procedure
B. Use of only glass collection tubes to reduce plastic-related injuries
C. Annual training for all employees with occupational exposure and free hepatitis B vaccination offered within 10 days of
assignment
D. Restriction of phlebotomy duties to employees who have completed five years of service
Correct Answer: C
Rationale: OSHA requires an exposure control plan that includes annual training, availability of hepatitis B vaccination at no cost
within 10 working days of initial assignment, and other engineering and work-practice controls.
Q4. During a busy morning draw, a phlebotomist notices that the sharps container on the cart is three-quarters full and
the lid no longer closes completely. What is the most appropriate action?
A. Replace the container immediately with a new one before continuing draws
B. Continue using it until it is completely full to avoid wasting containers
C. Empty the container into a larger biohazard bag and reuse it
D. Remove a few needles manually to create space and close the lid
Correct Answer: A
Rationale: Sharps containers must be replaced when they reach the fill line (usually three-quarters full) to prevent overfilling and
needlestick injuries. Containers are never emptied or reused by staff.
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, Q5. A patient in the outpatient clinic requests that the phlebotomist not wear gloves because the patient finds the latex
smell unpleasant. How should the phlebotomist respond?
A. Omit gloves for this single draw to maintain patient cooperation
B. Explain that gloves are required for every blood collection and offer non-latex gloves as an alternative
C. Wear gloves only on the hand holding the needle
D. Ask the patient to sign a waiver declining glove use
Correct Answer: B
Rationale: Standard precautions require gloves for every venipuncture. Patient preference does not override infection-control
requirements. Offering non-latex gloves addresses the concern while maintaining safety.
Q6. After completing a draw on a patient with known Clostridium difficile infection, the phlebotomist removes gloves
and prepares to leave the room. Which hand-hygiene method is required?
A. Wash hands with soap and water; alcohol-based hand rub is insufficient against C. difficile spores
B. Use alcohol-based hand sanitizer for at least 20 seconds
C. Rinse hands under running water without soap
D. Apply antimicrobial lotion and proceed to the next patient
Correct Answer: A
Rationale: C. difficile spores are not reliably killed by alcohol-based hand rubs. Soap-and-water hand washing is mandatory after
contact with patients or environments contaminated with C. difficile.
Q7. A new phlebotomist is orienting to the laboratory's fire-safety plan. Which class of fire extinguisher is appropriate
for an electrical fire involving a centrifuge?
A. Class C extinguisher
B. Class A extinguisher
C. Class B extinguisher
D. Class D extinguisher
Correct Answer: A
Rationale: Class C extinguishers are designated for electrical fires. Class A is for ordinary combustibles, Class B for flammable
liquids, and Class D for combustible metals.
Q8. While labeling tubes at the bedside, a phlebotomist accidentally drops a full EDTA tube, which shatters on the floor
and creates a blood spill approximately 8 inches in diameter. What is the correct sequence for spill cleanup?
A. Wipe the area quickly with paper towels and alcohol wipes so the next patient is not delayed
B. Don PPE, cover the spill with absorbent material, apply appropriate disinfectant, allow required contact time, then
dispose of materials as biohazard waste
C. Call environmental services and leave the area unattended until they arrive
D. Pour bleach directly on the spill and immediately mop the floor
Correct Answer: B
Rationale: Blood spills require PPE, containment with absorbent material, application of an EPA-registered disinfectant with
documented contact time, and proper biohazard disposal. Immediate mopping or leaving the spill unattended is unsafe.
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