NHCO Phlebotomy Certification Exam:
Comprehensive Study Guide with Practice
Questions and Solutions
Section 1: Phlebotomy Fundamentals (Questions 1–5)
Question 1: What is the primary purpose of phlebotomy? A) To diagnose infectious diseases
B) To collect blood specimens for laboratory analysis C) To administer intravenous medications
D) To measure blood pressure
Correct Answer: B Rationale: Phlebotomy is the practice of collecting blood specimens for
laboratory testing, which aids in diagnosis, monitoring, and treatment. It does not involve
administering medications (C) or measuring blood pressure (D), and while it can help diagnose
diseases (A), that is not its primary purpose.
Question 2: Which of the following is a phlebotomist’s scope of practice ? A) Interpreting lab
results B) Performing venipuncture and capillary punctures C) Prescribing blood tests D)
Administering blood transfusions
Correct Answer: B Rationale: Phlebotomists are trained to perform venipuncture and
capillary punctures for blood collection. Interpreting results (A), prescribing tests (C), and
administering transfusions (D) are outside their scope and require medical licensure.
Question 3: What is the minimum depth a needle should penetrate a vein during venipuncture?
A) One-fourth the diameter of the vein B) Halfway through the vein lumen C) Completely through
the vein D) Just beneath the skin surface
Correct Answer: B Rationale: The needle should penetrate at least halfway through the vein
lumen to ensure adequate blood flow. Shallow penetration (A, D) risks inadequate collection or
vein collapse; penetrating completely through (C) can damage the opposite vein wall.
,Question 4: Which of the following is a contraindication for venipuncture on a patient’s arm?
A) History of hypertension B) Presence of an AV fistula or graft C) Patient age over 65 D) Patient
with type 2 diabetes
Correct Answer: B Rationale: An AV fistula or graft (used for dialysis) must never be used
for venipuncture due to risk of infection, damage, or thrombosis. Hypertension (A), age (C),
and diabetes (D) are not absolute contraindications.
Question 5: What is the maximum recommended time a tourniquet should be applied during
venipuncture? A) 30 seconds B) 1 minute C) 2 minutes D) Until blood flow stops
Correct Answer: B Rationale: A tourniquet should be applied for no longer than 1 minute to
prevent hemoconcentration (altered lab results) or patient discomfort. Longer application (C,
D) risks hemolysis or venous stasis.
Section 2: Anatomy & Physiology for Phlebotomy (Questions 6–10)
Question 6: Which vein is the most common site for venipuncture in adults? A) Basilic vein B)
Cephalic vein C) Median cubital vein D) Radial vein
Correct Answer: C Rationale: The median cubital vein is the preferred site due to its size,
stability, and accessibility. The basilic (A) and cephalic (B) veins are alternatives but less ideal;
the radial vein (D) is rarely used for venipuncture.
Question 7: Which of the following veins is deep and not visible or palpable in most
patients? A) Cephalic vein B) Basilic vein C) Brachial vein D) Median antebrachial vein
Correct Answer: C Rationale: The brachial vein runs deep alongside the brachial artery and
is not typically visible or palpable . The cephalic (A), basilic (B), and median antebrachial (D)
veins are superficial and often visible/palpable.
Question 8: What is the function of the basilic vein? A) Draining blood from the hand B)
Connecting the cephalic and median cubital veins C) Running along the medial (inner) aspect of
the arm D) Supplying arterial blood to the forearm
Correct Answer: C Rationale: The basilic vein runs along the medial (inner) aspect of the
arm and is a common venipuncture site. It does not drain the hand (A), connect other veins (B),
or supply arterial blood (D).
, Question 9: Which of the following is a sign of vein collapse during venipuncture? A) Slow,
steady blood flow B) Sudden cessation of blood flow C) Bright red blood color D) Vein visibility
through the skin
Correct Answer: B Rationale: Sudden cessation of blood flow suggests the vein has
collapsed (e.g., due to excessive suction or shallow needle insertion). Slow flow (A) may
indicate partial collapse; bright red blood (C) suggests arterial puncture; visibility (D) is unrelated
to collapse.
Question 10: Which artery is located near the median cubital vein and must be avoided during
venipuncture? A) Radial artery B) Ulnar artery C) Brachial artery D) Cephalic artery
Correct Answer: C Rationale: The brachial artery runs adjacent to the median cubital vein.
Puncturing it can cause hematoma or arterial bleeding. The radial (A) and ulnar (B) arteries
are in the wrist/hand; there is no "cephalic artery" (D).
Section 3: Venipuncture Procedures (Questions 11–20)
Question 11: What is the correct angle for needle insertion during venipuncture? A) 5–10
degrees B) 15–30 degrees C) 45 degrees D) 90 degrees
Correct Answer: B Rationale: The needle should be inserted at a 15–30 degree angle to align
with the vein’s path and minimize trauma. Shallower angles (A) may miss the vein; steeper
angles (C, D) increase risk of penetrating through the vein.
Question 12: Which of the following is the correct order for donning PPE before venipuncture?
A) Gloves, gown, mask, face shield B) Gown, mask, face shield, gloves C) Mask, face shield,
gown, gloves D) Face shield, mask, gloves, gown
Correct Answer: C Rationale: The CDC-recommended order is: mask → face
shield/goggles → gown → gloves. This sequence prevents contamination of clean areas
(e.g., donning gloves last).
Question 13: What is the first step after selecting a venipuncture site? A) Apply the tourniquet
B) Cleanse the site with alcohol C) Palpate the vein D) Assemble the collection tubes
Comprehensive Study Guide with Practice
Questions and Solutions
Section 1: Phlebotomy Fundamentals (Questions 1–5)
Question 1: What is the primary purpose of phlebotomy? A) To diagnose infectious diseases
B) To collect blood specimens for laboratory analysis C) To administer intravenous medications
D) To measure blood pressure
Correct Answer: B Rationale: Phlebotomy is the practice of collecting blood specimens for
laboratory testing, which aids in diagnosis, monitoring, and treatment. It does not involve
administering medications (C) or measuring blood pressure (D), and while it can help diagnose
diseases (A), that is not its primary purpose.
Question 2: Which of the following is a phlebotomist’s scope of practice ? A) Interpreting lab
results B) Performing venipuncture and capillary punctures C) Prescribing blood tests D)
Administering blood transfusions
Correct Answer: B Rationale: Phlebotomists are trained to perform venipuncture and
capillary punctures for blood collection. Interpreting results (A), prescribing tests (C), and
administering transfusions (D) are outside their scope and require medical licensure.
Question 3: What is the minimum depth a needle should penetrate a vein during venipuncture?
A) One-fourth the diameter of the vein B) Halfway through the vein lumen C) Completely through
the vein D) Just beneath the skin surface
Correct Answer: B Rationale: The needle should penetrate at least halfway through the vein
lumen to ensure adequate blood flow. Shallow penetration (A, D) risks inadequate collection or
vein collapse; penetrating completely through (C) can damage the opposite vein wall.
,Question 4: Which of the following is a contraindication for venipuncture on a patient’s arm?
A) History of hypertension B) Presence of an AV fistula or graft C) Patient age over 65 D) Patient
with type 2 diabetes
Correct Answer: B Rationale: An AV fistula or graft (used for dialysis) must never be used
for venipuncture due to risk of infection, damage, or thrombosis. Hypertension (A), age (C),
and diabetes (D) are not absolute contraindications.
Question 5: What is the maximum recommended time a tourniquet should be applied during
venipuncture? A) 30 seconds B) 1 minute C) 2 minutes D) Until blood flow stops
Correct Answer: B Rationale: A tourniquet should be applied for no longer than 1 minute to
prevent hemoconcentration (altered lab results) or patient discomfort. Longer application (C,
D) risks hemolysis or venous stasis.
Section 2: Anatomy & Physiology for Phlebotomy (Questions 6–10)
Question 6: Which vein is the most common site for venipuncture in adults? A) Basilic vein B)
Cephalic vein C) Median cubital vein D) Radial vein
Correct Answer: C Rationale: The median cubital vein is the preferred site due to its size,
stability, and accessibility. The basilic (A) and cephalic (B) veins are alternatives but less ideal;
the radial vein (D) is rarely used for venipuncture.
Question 7: Which of the following veins is deep and not visible or palpable in most
patients? A) Cephalic vein B) Basilic vein C) Brachial vein D) Median antebrachial vein
Correct Answer: C Rationale: The brachial vein runs deep alongside the brachial artery and
is not typically visible or palpable . The cephalic (A), basilic (B), and median antebrachial (D)
veins are superficial and often visible/palpable.
Question 8: What is the function of the basilic vein? A) Draining blood from the hand B)
Connecting the cephalic and median cubital veins C) Running along the medial (inner) aspect of
the arm D) Supplying arterial blood to the forearm
Correct Answer: C Rationale: The basilic vein runs along the medial (inner) aspect of the
arm and is a common venipuncture site. It does not drain the hand (A), connect other veins (B),
or supply arterial blood (D).
, Question 9: Which of the following is a sign of vein collapse during venipuncture? A) Slow,
steady blood flow B) Sudden cessation of blood flow C) Bright red blood color D) Vein visibility
through the skin
Correct Answer: B Rationale: Sudden cessation of blood flow suggests the vein has
collapsed (e.g., due to excessive suction or shallow needle insertion). Slow flow (A) may
indicate partial collapse; bright red blood (C) suggests arterial puncture; visibility (D) is unrelated
to collapse.
Question 10: Which artery is located near the median cubital vein and must be avoided during
venipuncture? A) Radial artery B) Ulnar artery C) Brachial artery D) Cephalic artery
Correct Answer: C Rationale: The brachial artery runs adjacent to the median cubital vein.
Puncturing it can cause hematoma or arterial bleeding. The radial (A) and ulnar (B) arteries
are in the wrist/hand; there is no "cephalic artery" (D).
Section 3: Venipuncture Procedures (Questions 11–20)
Question 11: What is the correct angle for needle insertion during venipuncture? A) 5–10
degrees B) 15–30 degrees C) 45 degrees D) 90 degrees
Correct Answer: B Rationale: The needle should be inserted at a 15–30 degree angle to align
with the vein’s path and minimize trauma. Shallower angles (A) may miss the vein; steeper
angles (C, D) increase risk of penetrating through the vein.
Question 12: Which of the following is the correct order for donning PPE before venipuncture?
A) Gloves, gown, mask, face shield B) Gown, mask, face shield, gloves C) Mask, face shield,
gown, gloves D) Face shield, mask, gloves, gown
Correct Answer: C Rationale: The CDC-recommended order is: mask → face
shield/goggles → gown → gloves. This sequence prevents contamination of clean areas
(e.g., donning gloves last).
Question 13: What is the first step after selecting a venipuncture site? A) Apply the tourniquet
B) Cleanse the site with alcohol C) Palpate the vein D) Assemble the collection tubes
