NHA CPT Exam Prep 2025-2026

If a patient has done vigorous exercises (jogging, running, lifting, etc) within 8 hours prior to venipuncture, you should __________________ ?

Reschedule the appointment for another day.

A phlebotomist receives orders to draw an infant screening card, O2 levels, bilirubin, and DNA. Which should be performed first?

O2 levels.

An infant may cry due to the blood draw, so every attempt must be made to collect O2 levels as close to resting rate as possible

Why is the order of draw for capillary collections different than venipuncture?

Increased rate of coagulation

How much plasma does whole blood contain? (Expressed in percentage)

55% of whole blood is plasma

When a patient is fasting, a lipid panel should be drawn in a _______ top tube.

Gold (SST) top tube

Where is the best place to draw blood on a 9-month-old infant?

Either heel

What additive is inside Gold/SST and Red-Gray Speckled top tube?

Thixotropic gel for serum separation

When should the code on glucose cuvettes/strips be compared to the code on the glucometer?

When the patient is tested, no sooner

What is the first procedural step for a finger stick performed by a phlebotomist?

Confirm the correct identity of the patient.

Hemolyzation occur when a phlebotomist _________________?

Uses an incorrect needle gauge (too small of needle gauge like 25ga)

What is the order of draw for capillary blood collection according to CLSI?

1) EDTA Tubes (Lavender/Pink)

2) Heparin (Green)

3) Any other additives

4) Serum (Red/Gold/Tiger/Marble)

Define "basal state"

Fasting (nothing by mouth/NPO) and refraining from strenuous exercises for 8 (eight) to 10 (ten) hours prior to blood collection.

What is the correct depth of puncture for a capillary blood collection performed on an infant? (Expressed in millimeters/mm)

0.85 to 2.0 millimeters

The American Academy of Pediatrics (AAP) recommends that heel punctures NOT exceed _______________ millimeters for neonates and premature neonates.

0.85 millimeters

If a patient has recently had a masectomy on their RIGHT side, a blood sample should be drawn on __________________________.

The left arm.

Define "fibrinogen"

A protein that is converted into fibrin during normal blood clotting.

Define "hematocrit"

The ratio of total red blood cell volume to total blood volume, expressed as a percentage.

What is the difference between phlebitis and thrombophlebitis?

Both describes the inflammation of a vein but thrombophlebitis includes the formation of a (blood) clot.

Define "trough level" in a therapeutic drug

Lowest chemical blood level

Define "fibrillation"

Rapid, inefficient contractions of muscle fibers in the heart caused by disruption of nerve impulses.

Blood is classified into groups and types based on the presence of antigens on the surface of _________________________

Erythrocytes/red blood cells

Define "erythrocytes"

A cell that contains hemoglobin and carries oxygen throughout the body.

What is the average lifespan of erythrocytes?

120 days

How long does erythrocytes take to regenerate?

6 (six) to 8 (eight) weeks

Define "hemostasis"

Arrest of bleeding, whether by normal vasoconstriction, coagulation, or surgical means.

What is plasma?

Fluid portion of the blood in which the cellular components are suspended.

What make up the formed elements of blood?

Thrombocytes (platelets)

Erythrocytes (red blood cells)

Leukocytes (white blood cells)

What are the appropriate cleansers for a clean-catch urine collection?

Castille soap wipes

Benzalkonium Chloride (BZK) wipes

Which HEMATOLOGY tests may be performed from capillary blood collection?

(3 items)

1) Complete blood count (CBC)

2) Blood smears for manual white blood cell count

3) Hemoglobin & Hematocrit (H&H)

Why should you avoid using earlobes as a site for capillary blood collection?

This site causes the patient to feel nervous and their head may move around too much.

What is the function of thrombocytes?

Clotting and repairing of blood vessels

A patient states that they are severely allergic to latex, what should you do? (2 items)

1) Use nitrile gloves

2) In place of a traditional tourniquet, use a blood pressure cuff and inflate it to 40 mmHg

Quality control checklists ensure machines are inspected for compliance at time intervals specific to the equipment and _______________________.

Clinical application

How many minutes within collection of a urine specimen should the specimen temperature be taken?

4 (four) minutes

You witness a nurse receive a major electric shock from an instrument and immediately call 911. What should your FIRST action be PRIOR to calling 911?

Cutting off the instrument to eliminate the source of the electric shock

What interfacility conditions would require a phlebotomist to transport specimens in a closed container with ice packs?

If it is hot weather

Which test result is affected when povidone iodine is used to cleanse the site for a dermal puncture?

Potassium

Define "thrombophlebitis"

Inflammation of a vein with the formation of a blood clot

Define "nosocomial infection"

Infections acquired from healthcare settings

What is the most frequently occurring nosocomial infection for laboratory employees?

Hepatitis B

What term best describes red blood cells bursting because the plasma attached to them were not a match?

Agglutination

Calculate:

What is the total blood volume of an infant who weighs 3.3 kilograms?

(Average blood volume for an infant is 80mL/kg)

300 (three hundred) to 350 (three hundred fifty) mL

What is the average blood volume per kilogram for an adult male?

75 mL/kg

What is the average blood volume per kilogram for adult female?

65 mL/kg

What is the average blood volume per kilogram for an infant?

80 mL/kg

What is the average blood volume per kilogram for a neonate?

85 mL/kg

What is the average blood volume per kilogram for a premature neonate?

95 mL/kg

Isolation precaution is condensed into which three categories?

1) Airborne

2) Droplet

3) Contact

Serum is the liquid portion of _______________ blood

Coagulated

How much blood is found in the average adult body?

5 (five) to 7 (seven) liters

When should a blood sample for medication trough level be taken?

15 (fifteen) minutes prior to the next dose of medication

When a Gray top tube with an anticoagulation additive is centrifuged, what is the resulting fluid portion?

Plasma

According to OSHA requirements, a sharps container must be replaced __________________________.

When the container is 2/3 (two-thirds) full

What is the process in which blood vessels repair after injury?

Hemostasis

What is diastolic pressure?

Lowest level of arterial pressure

Bottom number of blood pressure reading

Arterioles, the smallest arteries, subdivide into?

Capillaries

What temperature must a semen specimen be at when in transport?

35 (thirty five) to 38 (thirty eight) degrees Celcius

Body temperature

What is the first step in blood collection procedure?

Test requisition

Capillary specimen collection is preferred over venipuncture when _________________

Veins are inaccessible

A phlebotomist collects multiple specimens on a premature infant. What is the possible complication of this procedure?

Iatrogenic anemia

When should an external liquid control for quality control on a CLIA-waived POC (point-of-care) test?

When a new lot number or kit is opened

Which of the following is the best indication that a patient is at risk of syncope?

>Involuntary movement

>Lightheadedness

>Petechiae

>Paleness and sweating

Paleness and sweating

What is the correct order for removing PPE after a procedure?

Gloves → Goggles → Gown → Mask

Which test results are prioritized when distributing lab results to ordering physicians?

Pre-surgical

Which CHEMISTRY tests may be performed from capillary blood collection?

(6 items)

1) Electrolytes

2) Glucose

3) Lipids (HDL/LDL Cholesterol)

4) Triglycerides

5) Hemoglobin A1C

6) Neonatal bilirubin

What is the pathway of pulmonary circulation?

Right ventricle → Lungs → Alveoli → Left ventricle

Except for capillaries, what are the three layers of main blood vessels?

1) Tunica adventitia (outer connective tissue layer)

2) Tunica media (middle, smooth, muscular layer)

3) Tunica intima (inner, endothelial layer)

What artery is avoided for venipuncture?

Brachial

What are the three layers of the heart called?

1) Endocardium (outer)

2) Myocardium (middle)

3) Epicardium (inner)

True or false:

The right and left sides of the heart are directly connected

False

What is the critical value for Troponin T levels?

0.3 ng/mL

Define "neutrophils"

Phagocyte cells that engulf and digests bacteria

Neutrophil count increases in response to ________________

Bacterial infection

Define "leukocytes"

A set of immune cells that provide infection protection from pathogen sand elements evoking an immune response.

What are the five types of leukocytes?

1) Neutrophils

2) Lymphocytes

3) Monocytes

4) Eosinophils

5) Basophils

Define "hemoglobin"

Oxygen carrying pigment in red blood cells

Define "embolus"

A sudden blockage in a blood vessel that has travelled and become lodged at a site too small for passage.

Blockages are caused by blood clots, air, lump of bacteria, and other foreign materials.

Which tube should be used when collecting serum for a chemistry test?

Red top

Gold top/SST

Tiger-top

What is the consequence of agglutination?

Release of a toxic amount of hemoglobin, which causes major kidney damage

What is the angle of entry used to draw blood from cephalic/median cubital/basilic vein on the upper extremities?

15 (fifteen) to 30 (thirty) degrees of entry

What is the preferred site for venipuncture?

Antecubital fossa

Why should you always wipe away the first drop of blood during capillary blood collection?

The first drop of blood is contaminated with thromboplastin, skin particles, tissue fluid, and alcohol which can alter test results.

Within which time period should a phlebotomist collect a newborn PKU blood-spot test?

Within 72 (seventy two) hours

What is the rhesus factor?

A protein that may or may not be present on an erythrocytes surface

True or false:

Blood is Rh positive if the rhesus protein is not present on the erythrocytes' surface

False

What occurs during the platelet phase of hemostasis?

Platelets adhere to the endothelial lining due to injury to the blood vessel

Define "postprandial"

After a meal

What is the reaction that characterize the vascular phase of hemostasis?

Vasoconstriction in response to an injury to the blood vessel

Describe the boundaries appropriate for a heel puncture

The medial line extending from the great toe and lateral line extending from the fourth and fifth digit

Which stage of hemostasis does a cascade of interactions between coagulation factors that convert temporary platelet plugs to a stable fibrin clot?

Coagulation phase

How are the four major blood groups determined?

Each group is the determined by the presence or absence of two antigens, A & B

Which blood type is a universal recipient?

AB positive

What does HBV stand for?

Hepatitis B Virus

What is the most common/frequently occuring nosocomial infection for NON-EMPLOYEES?

Respiratory infection

How many hours does a patient have to return to the lab with their at-home collection semen specimen?

One hour

How many minutes should you rinse with water after receiving a chemical spill to exposed skin?

15 (fifteen) minutes

When teaching a patient to collect a sputum sample at home, what is the most important thing to emphasize?

The patient should take a deep breath and cough before spitting into the collection container

What are the requirements from OHSA for healthcare personnel who are potentially or routinely exposed to Hepatitis B?

1) Must receive a no-cost Hep B vaccine, provided by the employer

OR

2) Signed declination/exemption form

What is the pathway of systemic circulation?

Inferior & superior vena cava → Right atrium → Tricuspid valve → Right ventricle → Pulmonic valve

What is a potential consequence of mislabeling BLOOD BANK specimen?

Fatal transfusion reaction