Phlebotomy Board Exam 2023

Which of the following statements is not one of the 3 major goals of the Patient's Bill of Rights?

A. Assures that the health care system is fair and it works to meet patients' needs

B. Gives patients a way to address any problems they may have

C. Encourages patients to take an active role in staying or getting healthy

D. Ensures that the care you receive is affordable

D. Ensures that the care you receive is affordable

Which of the following duties is outside the scope of the phlebotomist's practice?

A. Collecting a tissue sample

B. Labeling samples correctly

C. Drawing blood using the appropriate equipment

D. Identifying patients properly

A. Collecting a tissue sample

In delivering quality patient care, which of the following actions should be avoided?

A. Excessive punctures

B. Repeated draws

C. Probing on their medical condition

D. All of the above.

D. All of the above.

What federal agency regulates phlebotomy certifications?

A. Center for Disease Control (CDC)

B. National Institutes of Health (NIH)

C. Health & Human Services

D. None of the above

D. None of the above

It is not a federally regulated procedure

If you encounter a hazardous chemical that you need more information about, where can you quickly and accurately locate that information?

A. Employee manual

B. Material Safety Data Sheet (MSDS)

C. By searching on the Internet

D. Procedural manual

B. Material Safety Data Sheet (MSDS)

Being free from contamination or germs is referred to as what term?

A. Asepsis

B. Healthy

C. Sepsis

D. Clean.

A. Asepsis

Implied consent form a patient to draw blood would be obtained by which action?

A. The patient signs a consent form

B. The patient verifies their identity

C. The patient extends their arm

D. All of the above.

C. The patient extends their arm

When collecting a sample to determine blood alcohol levels, what color tube should be used?

A. Yellow

B. Red

C. Royal Blue

D. Gray

D. Gray

If a sample needs to be diluted, what should be added?

A. Anticoagulant

B. Preservative

C. Diluent

D. All of the above.

C. Diluent

Potassium EDTA binds to what element in the blood?

A. Iron

B. Calcium

C. Magnesium

D. All of the above

B. Calcium

A failure to fast when ordered can impact a blood sample in which of the following ways?

A. Increasing its turbidity

B. Increasing stress hormones

C. Increasing enzymes such as creatinine and fatty acids

D. A false increase in analytes.

A. Increasing its turbidity

If you notice that the name of a patient is spelled differently on the requisition and a patient's armband, what it the best course of action?

A. Assume there was a typo and ignore the requisition

B. Visit with your manager to verify the information and have it corrected

C. Ask the patient to go get the requisition corrected

D. Any of the above.

B. Visit with your manager to verify the information and have it corrected

Anchoring a vein properly requires which of the following actions?

A. Placing your thumb to the side of the vein and pressing firmly

B. Placing the thumb of your free hand below the vein and stretching the skin

C. Increasing pressure on the tip of the needle

D. All of the above.

B. Placing the thumb of your free hand below the vein and stretching the skin

The most common cause of contamination in blood cultures is which of the following?

A. Improper site preparation

B. Improper transportation

C. Improper storage

D. All of the above.

A. Improper site preparation

What is another name for a thrombocyte?

A. Platelet

B. Thrombus

C. White blood cell

D. Plasma

A. Platelet

Inserting a needle at the point of divergence between veins can result in what?

A. An increased chance of a hematoma

B. Nerve damage

C. Failed venipuncture

D. Nothing. This is an ideal spot for venipuncture.

A. An increased chance of a hematoma

Which of the following is a complication that can arise in capillary sampling?

A. Collapse of veins

B. Nerve Damage

C. Scarring

D. All of the above.

D. All of the above.

Approximately how many liters of blood is generally found in the adult human body?

A. 2 liters

B. 3 liters

C. 5 liters

D. 10 liters

C. 5 liters

Which of the following is a cause for the rejection of a specimen?

A. Improper specimen (serum, blood, plasma)

B. Incomplete chain of custody documentation

C. Insufficient quantity

D. All of the above.

D. All of the above.

A failure to allow alcohol to completely dry during site preparation can lead to what?

A. Hemolysis

B. Hemoconcentration

C. Hematoma

D. There is no impact if the alcohol fails to completely dry

A. Hemolysis

The process of maintaining control of a specimen from the point of collection until testing is complete is referred to as what?

A. Chain of custody

B. Specimen tracking

C. Patient control

D. None of the above.

A. Chain of custody

An incident reporting system should include which of the following components?

A. Details of the incident

B. Potential causes

C. Management of adverse events

D. All of the above

D. All of the above

Which of the following is not required on a correctly completed requisition?

A. Patient history

B. Priority status

C. Test(s) ordered

D. Patient number

A. Patient history

Which of the following is a National Patient Safety Goal(s)?

A. Identify the patient correctly

B. Prevent infection

C. Improve communication

D. All of the above.

D. All of the above.

Workplace safety in a lab is governed by which agency?

A. Center for Disease Control (CDC)

B. National Institutes of Health (NIH)

C. Federal Emergency Management Administration (FEMA)

D. Occupational Safety and Health Administration (OSHA).

D. Occupational Safety and Health Administration (OSHA).

What is the proper sequence for putting on PPE?

A. Gloves, Gown, Mask

B. Mask, Gloves, Gown

C. Gown, Mask, Gloves

D. Mask, Gown, Gloves

C. Gown, Mask, Gloves

When should a sharps container be disposed of?

A. After it is half full

B. When it is 3/4 full

C. When it is completely full

D. Never. They are reusable.

B. When it is 3/4 full

Which of the following draws can be collected after drawing a gray tube (sodium fluoride/potassium oxalate with antiglycolytic inhibitor)?

A. Blood culture (yellow with SPS)

B. Sodium citrate tubes (light blue)

C. Heparin tubes with or without gel (light or dark green)

D. None of the above.

D. None of the above.

The additive 3.2% sodium citrate results in what?

A. The prevention of clotting by binding calcium

B. Activation of clotting with glass or silica particles

C. Prevention of clotting by inhibiting thrombin and thromboplastin

D. Prevention of clotting by inhibiting glycolysis.

A. The prevention of clotting by binding calcium

Venipuncture should not be performed on which of the following sites?

A. Sites with scar tissue

B. Sites with hematomas present

C. Sites with vascular grafts

D. All of the above.

D. All of the above.

The use of povidone iodine for site preparation can result in a false increase in what level?

A. Potassium

B. Phosphorus

C. Uric Acid

D. All of the above.

D. All of the above.

Prior to drawing from a sleeping patient, what should be done?

A. Leave and return later when they are awake

B. Verify their identity on the armband and proceed with the draw

C. Gently wake them up, and when they are ready, request they provide verification of their identity

D. Check their medical chart.

C. Gently wake them up, and when they are ready, request they provide verification of their identity

What type of draw is generally performed for patients in infancy?

A. Fingerstick

B. Heel stick

C. Venipuncture

D. Arterial.

B. Heel stick

Which of the following would not be required for a finger stick?

A. Syringe

B. Gauze

C. Alcohol wipes

D. Micro containers for the requested tests.

A. Syringe

Which of the following is a characteristic of capillaries?

A. They are permeable for every substance

B. They are found in every square inch of the human body

C. Their walls are rugged

D. Capillaries are only a small part of the vascular system.

B. They are found in every square inch of the human body

What action can prevent bruises from forming due to a blood draw?

A. Applying firm pressure immediately after and keeping a bandage on for several hours

B. Taking ibuprofen

C. Applying heat

D. All of the above.

A. Applying firm pressure immediately after and keeping a bandage on for several hours

Which test order should be given the most priority?

A. STAT

B. Urgent

C. Timed

D. Routine.

A. STAT

Which of the following is not a primary method of venipuncture?

A. Vacuum Tube

B. Lancet

C. Syringe

D. Butterfly.

B. Lancet

Why is blood drawn in a specific order?

A. To reduce pain and patient discomfort

B. To avoid cross-contamination of additives

C. To facilitate transportation of the specimens

D. All of the above.

B. To avoid cross-contamination of additives

When a sample is rejected for QNS, what is the appropriate response?

A. Collect another sample while protecting from light

B. Collect another sample with sufficient quantity

C. Analyze the label for missing information

D. Redraw the blood in the proper order.

B. Collect another sample with sufficient quantity

Which of the following examples is not a HIPAA violation?

A. Accessing the health record of family members or friends

B. Providing court-ordered health information

C. Accidentally losing an unencrypted laptop

D. Providing a patient with a copy of requested health records within 60 days.

B. Providing court-ordered health information

What is the first step in dealing with a patient that appears nervous?

A. Discuss the procedure in detail

B. Assess their cause for concern and provide reassurance

C. Double check with the ordering physician to determine if the draw is truly necessary

D. Tell them to close their eyes.

B. Assess their cause for concern and provide reassurance

Which of the following terms describes a management function whereby control of the quality of raw materials, assemblies, produced materials and components; services related to production; and management, production and inspection processes is exercised for the purpose of preventing undetected production of defective material or rendering of faulty services?

A. HIPAA compliance

B. Quality control

C. Quality care

D. Best practices.

B. Quality control

Which of the following can reduce your risk of infection after being exposed to a bloodborne pathogen such as Hepatitis B or HIV?

A. Taking a post-exposure prophylaxis

B. Reporting the incident

C. Discussing the exposure with your physician

D. All of the above.

A. Taking a post-exposure prophylaxis

What types of safety hazard might you encounter while working as a phlebotomist?

A. Biological

B. Electrical

C. Radioactive

D. All of the above

D. All of the above

Which of the following can result in legal or criminal actions against the phlebotomist?

A. Breach of confidentiality

B. Holding a patient down to obtain a sample

C. Median nerve damage related to a negligent draw

D. All of the above.

D. All of the above.

When a patient's vein is small, thin or fragile, what would be the most appropriate equipment selection?

A. Evacuated tube system

B. Syringe

C. Straight, multi sample needle

D. Additional bandages

B. Syringe

Which of the following needle gauge sizes has the largest bore (opening)?

A. 18 G

B. 21 G

C. 22 G

D. 25 G

A. 18 G

How long should a tube be pre-warmed in an incubator prior to collecting a warmed specimen, such as Cold Agglutinins?

A. 5 minutes

B. 10 minutes

C. 30 minutes

D. 60 minutes.

C. 30 minutes

Which cleansing agent is typically used first on venipuncture for the collection of blood cultures or blood alcohol specimens?

A. Chlorhexidine gluconate

B. Povidone-iodine.

C. Isopropyl alcohol

D. All of the above.

C. Isopropyl alcohol

What is an acceptable method of patient identification?

A. Viewing a patient respond when you call their name

B. Having a member of their family tell you their name

C. Requesting that the patient provide their name and date of birth

D. All of the above.

C. Requesting that the patient provide their name and date of birth

If a patient indicates previous experiences of fainting during venipuncture, what should be done?

A. You should draw the blood normally, while keeping an eye on them

B. Another staff member's presence should be requested in case you need assistance

C. You should provide them with cookies or juice to increase their blood sugar level

D. You may move them to an area in which they can lie down during the draw.

D. You may move them to an area in which they can lie down during the draw.

Which of the following tests does not require fasting?

A. Lipid profile

B. Renal function panel (CRF)

C. Iron test (TIBC)

D. Complete blood count (CBC).

D. Complete blood count (CBC).

What are the smallest veins in the human body?

A. Capillaries

B. Arterioles

C. Venules

D. Vena cava.

C. Venules

Which of the following actions is standard practice when collecting a blood smear?

A. Cleaning a slide with isopropyl alcohol and letting it dry

B. Spreading the finger across the entire slide

C. Placing the finger to the slide immediately after puncture

D. All of the above

A. Cleaning a slide with isopropyl alcohol and letting it dry

What is the smallest gauge needle used for venipuncture?

A. 18

B. 20

C. 22

D. 23

D. 23

Which test is not impacted by fasting?

A. Glucose

B. Blood culture

C. Cholesterol

D. Triglycerides.

B. Blood culture

Which of the following is not a standard vacuum tube size?

A. 2 ml

B. 3 ml

C. 10 ml

D. 20 ml

D. 20 ml

What is the most common cause of blood culture contamination?

A. Improper draw order

B. Contaminated needles

C. Expired tubes

D. Improper skin preparation

D. Improper skin preparation

When checking inventory, which of the following elements needs to be verified for use?

A. The expiration date has not lapsed

B. There is no visible damage to the equipment

C. There is no heat and moisture damage

D. All of the above

D. All of the above

Which of the following may occur if additives are not mixed adequately?

A. Clotting of the sample

B. Erroneous test results

C. A repeat draw will be necessary

D. All of the above

D. All of the above

What action should not be taken when first meeting a patient?

A. Introduce yourself

B. Request that the patient verify their identification

C. Inquire the reason they need their blood drawn

D. Confirm that the laboratory form matches their identity.

C. Inquire the reason they need their blood drawn

Under what circumstances should a tube be pre-labeled?

A. During an emergency

B. When the patient states they are in a hurry

C. When there are multiple draws

D. Never.

D. Never.

The presence of an adequate number of sharps containers reduces the risk of needle injuries occurring from which of the following actions?

A. Needle recapping

B. Decanting of used sharps containers

C. Overfilled sharps containers

D. All of the above.

D. All of the above.

After which action is it acceptable to not wash your hands?

A. After removing gloves

B. Before leaving the workplace

C. Before going to the restroom

D. None of the above.

D. None of the above.

How many unsuccessful attempts at venipuncture are allowed before seeking additional assistance is required?

A. One

B. Two

C. Three

D. You are allowed as many as you need.

B. Two

For elderly patients, in what circumstances would a capillary puncture be performed rather than venipuncture?

A. The patient is immobile

B. The patient's skin is thin

C. The patient has a tendency to form clots

D. The patient has deteriorated muscle tone

C. The patient has a tendency to form clots

Which tube color has no additive?

A. Light blue

B. Red

C. Gold

D. Green.

B. Red

What test requires that it be chilled in ice right after collection?

A. Arterial Gases

B. Ammonia

C. Lactic Acid

D. All of the above

D. All of the above

If one is used, when should the tourniquet be removed?

A. Prior to puncture

B. Prior to withdrawal

C. After it's been in place for 30 seconds

D. After withdrawal.

B. Prior to withdrawal

What may occur if a tourniquet is left on too long?

A. Numbness

B. Skin Tears

C. Extremity color and temperature change

D. All of the above.

D. All of the above.

If you cannot palpate a vein on the patient's dominant arm, what should be done?

A. Check the other arm

B. Collect a capillary sample

C. Have another phlebotomist check

D. Use your instinct to guess where it is located.

A. Check the other arm

What is the maximum depth a heel stick should penetrate?

A. 2.0 mm

B. 0.5 mm

C. 1.0 mm

D. 3.0 mm.

A. 2.0 mm

In what location are nutrients and gasses exchanged in the body?

A. In the chambers of the heart

B. In the capillaries

C. Along the surface of the vein

D. In subcutaneous fat.

B. In the capillaries

Septicemia can be detected by what type of test?

A. D-dimer

B. HbA1c test

C. Blood culture

D. Kidney function test.

C. Blood culture

Which color tube needs to be filled completely?

A. Light Blue

B. Yellow/gold

C. Lavender

D. Gray

A. Light Blue

What can be done to make drawing easier on a patient with rolling veins?

A. You can apply a tourniquet

B. You can select a smaller gauge needle

C. You can anchor the vein

D. You can use a lancet.

C. You can anchor the vein

Which of the following tubes would be filled first?

A. Light Blue

B. Red

C. Lavender

D. Yellow

A. Light Blue

If an intoxicated person refuses a blood sample to determine the presence of alcohol or drugs at the request of a police officer, what is the best course of action?

A. Obtain the police officer's permission to get the sample

B. Nothing. The patient has the right to refuse the test

C. Request that the officer get a warrant

D. Discuss the importance of the test and try to get them to change their mind.

C. Request that the officer get a warrant

What is the optimal angle in which a needle should be inserted in order to minimize the likelihood that the needle will go all the way through the vein?

A. Less than 5 degrees

B. 15-30 degrees

C. 45-60 degrees

D. 90 degrees.

B. 15-30 degrees

When performing quality control checks, tubes should be discarded under which circumstances?

A. Their expiration date is approaching

B. The stopper has small cracks

C. The tubes have no loss of vacuum

D. There is no visible sign of defect.

B. The stopper has small cracks

When should tubes be labeled?

A. Before greeting the patient

B. Before drawing the specimen

C. After the draw, but before exiting the patient's room

D. After leaving the patient's room.

C. After the draw, but before exiting the patient's room

If a patient refuses to have their blood drawn, what is the best course of action?

A. Leave the room and have another phlebotomist attempt to draw from them

B. Firmly request that they sit and ensure that you collect the sample

C. Let them wait for a while and see if they change their mind

D. Notify a supervisor and document the patient's refusal.

D. Notify a supervisor and document the patient's refusal.

How long should you observe the site prior to bandaging?

A. Bandage immediately

B. 2 seconds

C. 5 seconds

D. 10 seconds.

C. 5 seconds

When washing your hands, why is it important to stand back from the sink?

A. So that you do not get wet

B. So that you can scrub for a longer period of time

C. Because the sink may be contaminated

D. All of the above.

C. Because the sink may be contaminated

Which of these does not work to control infection?

A. PPE

B. Washing hands

C. Contamination

D. Sharps containers.

C. Contamination

Which antiseptic should not be used on pre-term infants or those under 2 months of age?

A. Chlorhexidine gluconate

B. Povidone-iodine

C. Isopropyl alcohol

D. All of the above.

A. Chlorhexidine gluconate

If a patient indicates an allergy to latex, what is the proper action?

A. Wearing no gloves

B. Minimizing contact with latex gloves

C. Wear nitrile gloves

D. All of the above.

C. Wear nitrile gloves

What is the proper material used to stop bleeding after collection?

A. Alcohol prep pad

B. Tissue

C. Gauze

D. Any of the above.

C. Gauze

When preparing to draw a gentamycin peak and trough, what element should the phlebotomist pay particular attention to?

A. Fasting status

B. Prior physical activity

C. Patient status as a smoker

D. The timing instructions

D. The timing instructions

Palpation describes what process?

A. Searching for a vein using pressure and release

B. Disinfecting a selected site

C. Identifying the patient using defined standards

D. Disposing of equipment used in a collection

A. Searching for a vein using pressure and release

What field is unnecessary on an infant's blood sample label?

A. Infant's first name

B. Mother's name

C. Phlebotomist identification

D. Infant Gender.

A. Infant's first name

Which test requires the collection of both blood and urine at specific intervals?

A. Blood urea nitrogen (BUN)

B. Arterial blood gas (ABG)

C. Glucose tolerance testing

D. Liver function tests

C. Glucose tolerance testing

What is the best spot for completing a finger stick?

A. The center of the 2nd finger

B. The side of the 5th finger

C. The center of the thumb

D. The side of the 3rd finger

D. The side of the 3rd finger

Which test requires the sample to be protected from light?

A. Glucose

B. Basic metabolic panel

C. Iron

D. Bilirubin.

D. Bilirubin.

For adult patients, what is the maximum length lancet that should be used for a fingerstick?

A. 8.5 mm

B. 1.5 mm

C. 2.2 mm

D. 2.4 mm

C. 2.2 mm

If you experience a patient pumping their fists during a blood draw, what can you do?

A. Politely explain to them that this can elevate ionized calcium and potassium levels and request that they stop

B. Nothing, they are probably just nervous and it is ok to let them continue

C. Have them pump their fists faster to speed up the draw

D. Try talking to them about something else so that they will forget about

A. Politely explain to them that this can elevate ionized calcium and potassium levels and request that they stop

During blood coagulation, what is formed?

A. A fibrin clot

B. Plasma

C. Serum

D. Pulmonary embolism.

A. A fibrin clot

If a patient is misidentified, what should happen?

A. The specimen should be discarded and recollected

B. The specimen should be relabeled

C. The specimen should be tested anyway

D. None of the above.

A. The specimen should be discarded and recollected

The veins of patients undergoing chemotherapy are especially challenging for venipuncture due to what characteristics?

A. Their blood flow is much weaker

B. They roll much easier

C. They are smaller, less elastic, and sometimes sclerosed

D. All of the above.

C. They are smaller, less elastic, and sometimes sclerosed