OHIO SCHOOL OF PHLEBOTOMY COMPREHENSIVE EXAMS
2025/2026 ANSWERS AND QUESTIONS GRADED A+
✔✔Needle gauge - ✔✔21 and 22 most common
(green and black)
smaller_23-25 fragile veins
larger16-18-blood donation
✔✔lancet - ✔✔used when smaller amount of blood needed on adults or infants
standard blade is 2.4 mm puncture only capillary bed
✔✔Non-evacuated blood collection system - ✔✔syringe draw (prone to collapse veins
✔✔Beveling - ✔✔end the draw, hissing noise, noise,unsterile
✔✔bandage - ✔✔needs to be on for ablest 15 min to make sure clotted
✔✔Touriquet - ✔✔no longer than 2 min on causes hemoconcentration or hemolyzed
sample,can use blood pressure cuff instead 60mmhg or lower.engorge veins
✔✔AC - ✔✔antecubital fossa:inside of elbow.most common location for draw
✔✔Vein Selection - ✔✔locations:center veins-most likely deeper(don't marry
area),superficial veins move more,outside vein-difficult for angle
size: larger not always better, right size needle picked, anchored veins better
depth: deep veins usually have better flow.less likely to be damaged
direction-long sections(are ideal veins) straight best, avoid confluence-y(connecting
veins)
condition:always ask patient whats going on with vein, sclerotic vein unsuitable but
sometimes good for druggies
turgor-bounce of vein, veins don't have it might not work even if you see vein. can be in
vein but receive no blood due to a druggie vein or dehydration
✔✔median cubital vein - ✔✔The vein of choice because is it large and does not tend to
move the the needle is inserted. supportive tissue for stability, least likely to develop
hematoma
✔✔Cephalic vein - ✔✔outside arm, straight,easy to see, superficial(more to surface)
2nd choice, harder to palpate, small vein butterfly
✔✔basalic vein - ✔✔last choice of ac,inside arm/large,easy to palpate on top of median
contanious nerve and bracial artery,risk of pain and injury of nerves, no fishing need to
direct
,✔✔hard or core like vein - ✔✔difficult to enter(only do so if needed)
✔✔deep vein - ✔✔better flow, difficult to palpate tighter tourniquet
✔✔small vein - ✔✔never use spider veins, can't palpate,make sure vein can support
needle, largest needle, anchor more aggressively
✔✔swollen veins - ✔✔larger vein(rare in arm)
not suitable for draw
difference in blood flow
collapse
✔✔hand draws - ✔✔smaller gauge needle
butterfly needle
avoid valves(branch off veins, bumpy)
stabilize patient
adjust angle of entry depth(superficial)
anchor firmly(not supported well)
✔✔SPECIMEN LABELS SHOULD INCLUDE - ✔✔patients full name
the date and time of collection
the type of specimen
✔✔purpose of standard precautions - ✔✔protect patients and yourself from illness and
injury
✔✔when should u label tube - ✔✔patient in room
✔✔disadvantage of small needle - ✔✔hemmlysed samples can occur and can damage
blood cells
✔✔nerve damage - ✔✔uncommon ,ac near basilic vein close to median cutaneous
nerve traveling with brachial artery(main nerve of hand) end draw
✔✔Bumpy Veins - ✔✔Unsuitable- may mean vein is thromboses or extremely vascular
✔✔deep veins - ✔✔very suitable-common in heavy arms; usually large and well
anchored; may need to adapt
✔✔muscular arms - ✔✔Suitable- veins may lie over muscle or bone and lack tissue
support
✔✔heavy arms - ✔✔Suitable- veins barely palpable, but large and well anchored
, ✔✔hard-core-like veins - ✔✔unsuitable-sclerotic veins usually, common among elderly
✔✔rolling veins - ✔✔Unsuitable- Lack good tissue support & "roll" away from needle
✔✔small veins - ✔✔Unsuitable- may be usable with appropriate distention, smaller
caliber needle
✔✔Swollen veins - ✔✔Unsuitable- likely varicose or contain valve,concluence
(obese,pregnant or cardiovascular disorders
✔✔order of draw - ✔✔yellow plastic, light blue,(gold,tiger red, red), green(mint, dark
green, tiger,light green), lavender,white/pearl,gray and other
✔✔plastic yellow tube - ✔✔1st- anticoagulant,preservative, blood culture, sodium
polyanethol sulfonate,sps test preserve for 2-4hrs transferred to bottles
✔✔Light Blue Tube - ✔✔2nd-Sodium Citrate: pt ptt pt/inr, 9:1 ratio, reversable
anticoagulant(won't clot) plasma,fibrinogen
✔✔red tube - ✔✔3rd- no additive has silicone coat(plastic), (glass) clot activator , clot
tune,
obtaining serum:chemistries.
test: abo/rg,crossmatch, digoxin,tegretol,dilatin/phenytoin
✔✔red tiger/gold - ✔✔3rd-clot activator;seperation gel
obtaining serum
bmp,cmp,bilirubin,thryoid testing, hormone levels, antibiotics,hepatitis,general
chem,ckmb,hcg,psa,ck
✔✔orange tube- - ✔✔3rd- thrombin-based clot activator;seperation gel(in some)
✔✔green tube - ✔✔4th-sodium or lithium heparin
anticogulant
plasma chemistry/electrolytes
test;electrolytes,bmp,cmp,glucose,potassium,troponin,lactate (on ice)
✔✔Lavander tube - ✔✔5th-(pink sometimes/blood bank) k3 edta(glass) k2 edta(plastic)
(don't spin) cbc,esr, hemoglobin(hgb a1c)
anticoagulant,cbc,
preserve artifacts up to 12 hours no partial tubes
test:cbc,wbc,hct,esr,platelet count, ammonia(on ice), hgba1c,rbc,hgb,diff
✔✔white tube - ✔✔6th-ppt k2edta:seperation gel,anticogulant, molecure diagnostic
2025/2026 ANSWERS AND QUESTIONS GRADED A+
✔✔Needle gauge - ✔✔21 and 22 most common
(green and black)
smaller_23-25 fragile veins
larger16-18-blood donation
✔✔lancet - ✔✔used when smaller amount of blood needed on adults or infants
standard blade is 2.4 mm puncture only capillary bed
✔✔Non-evacuated blood collection system - ✔✔syringe draw (prone to collapse veins
✔✔Beveling - ✔✔end the draw, hissing noise, noise,unsterile
✔✔bandage - ✔✔needs to be on for ablest 15 min to make sure clotted
✔✔Touriquet - ✔✔no longer than 2 min on causes hemoconcentration or hemolyzed
sample,can use blood pressure cuff instead 60mmhg or lower.engorge veins
✔✔AC - ✔✔antecubital fossa:inside of elbow.most common location for draw
✔✔Vein Selection - ✔✔locations:center veins-most likely deeper(don't marry
area),superficial veins move more,outside vein-difficult for angle
size: larger not always better, right size needle picked, anchored veins better
depth: deep veins usually have better flow.less likely to be damaged
direction-long sections(are ideal veins) straight best, avoid confluence-y(connecting
veins)
condition:always ask patient whats going on with vein, sclerotic vein unsuitable but
sometimes good for druggies
turgor-bounce of vein, veins don't have it might not work even if you see vein. can be in
vein but receive no blood due to a druggie vein or dehydration
✔✔median cubital vein - ✔✔The vein of choice because is it large and does not tend to
move the the needle is inserted. supportive tissue for stability, least likely to develop
hematoma
✔✔Cephalic vein - ✔✔outside arm, straight,easy to see, superficial(more to surface)
2nd choice, harder to palpate, small vein butterfly
✔✔basalic vein - ✔✔last choice of ac,inside arm/large,easy to palpate on top of median
contanious nerve and bracial artery,risk of pain and injury of nerves, no fishing need to
direct
,✔✔hard or core like vein - ✔✔difficult to enter(only do so if needed)
✔✔deep vein - ✔✔better flow, difficult to palpate tighter tourniquet
✔✔small vein - ✔✔never use spider veins, can't palpate,make sure vein can support
needle, largest needle, anchor more aggressively
✔✔swollen veins - ✔✔larger vein(rare in arm)
not suitable for draw
difference in blood flow
collapse
✔✔hand draws - ✔✔smaller gauge needle
butterfly needle
avoid valves(branch off veins, bumpy)
stabilize patient
adjust angle of entry depth(superficial)
anchor firmly(not supported well)
✔✔SPECIMEN LABELS SHOULD INCLUDE - ✔✔patients full name
the date and time of collection
the type of specimen
✔✔purpose of standard precautions - ✔✔protect patients and yourself from illness and
injury
✔✔when should u label tube - ✔✔patient in room
✔✔disadvantage of small needle - ✔✔hemmlysed samples can occur and can damage
blood cells
✔✔nerve damage - ✔✔uncommon ,ac near basilic vein close to median cutaneous
nerve traveling with brachial artery(main nerve of hand) end draw
✔✔Bumpy Veins - ✔✔Unsuitable- may mean vein is thromboses or extremely vascular
✔✔deep veins - ✔✔very suitable-common in heavy arms; usually large and well
anchored; may need to adapt
✔✔muscular arms - ✔✔Suitable- veins may lie over muscle or bone and lack tissue
support
✔✔heavy arms - ✔✔Suitable- veins barely palpable, but large and well anchored
, ✔✔hard-core-like veins - ✔✔unsuitable-sclerotic veins usually, common among elderly
✔✔rolling veins - ✔✔Unsuitable- Lack good tissue support & "roll" away from needle
✔✔small veins - ✔✔Unsuitable- may be usable with appropriate distention, smaller
caliber needle
✔✔Swollen veins - ✔✔Unsuitable- likely varicose or contain valve,concluence
(obese,pregnant or cardiovascular disorders
✔✔order of draw - ✔✔yellow plastic, light blue,(gold,tiger red, red), green(mint, dark
green, tiger,light green), lavender,white/pearl,gray and other
✔✔plastic yellow tube - ✔✔1st- anticoagulant,preservative, blood culture, sodium
polyanethol sulfonate,sps test preserve for 2-4hrs transferred to bottles
✔✔Light Blue Tube - ✔✔2nd-Sodium Citrate: pt ptt pt/inr, 9:1 ratio, reversable
anticoagulant(won't clot) plasma,fibrinogen
✔✔red tube - ✔✔3rd- no additive has silicone coat(plastic), (glass) clot activator , clot
tune,
obtaining serum:chemistries.
test: abo/rg,crossmatch, digoxin,tegretol,dilatin/phenytoin
✔✔red tiger/gold - ✔✔3rd-clot activator;seperation gel
obtaining serum
bmp,cmp,bilirubin,thryoid testing, hormone levels, antibiotics,hepatitis,general
chem,ckmb,hcg,psa,ck
✔✔orange tube- - ✔✔3rd- thrombin-based clot activator;seperation gel(in some)
✔✔green tube - ✔✔4th-sodium or lithium heparin
anticogulant
plasma chemistry/electrolytes
test;electrolytes,bmp,cmp,glucose,potassium,troponin,lactate (on ice)
✔✔Lavander tube - ✔✔5th-(pink sometimes/blood bank) k3 edta(glass) k2 edta(plastic)
(don't spin) cbc,esr, hemoglobin(hgb a1c)
anticoagulant,cbc,
preserve artifacts up to 12 hours no partial tubes
test:cbc,wbc,hct,esr,platelet count, ammonia(on ice), hgba1c,rbc,hgb,diff
✔✔white tube - ✔✔6th-ppt k2edta:seperation gel,anticogulant, molecure diagnostic
