NHA Practice test questions

Two glass tubes break while processing in a centrifuge. Which of the following actions should a phlebotomist take while cleaning?

The phlebotomist should always don __________ when handling broken glass, along with all required personal protective equipment (PPE), before handling bodily fluids.

Don heavy duty gloves and a face shield.

Which of the following are the proper handling instructions for an EDTA tube collected for a CBC blood test?

Using this device is the best method for ensuring accurate test results for a CBC test.

Place the tube in an automatic rocking device.

A phlebotomist is collecting a urine specimen from a patient for a pre-employment drug screening. Which of the following findings should indicate that tampering may have occurred? The temperature of the specimen is 30° C (86° F).

The phlebotomist should identify that a specimen temperature of 30° C (86° F) is below the expected range of 32° to 38° C (90° to 100° F) and indicates that tampering may have occurred.

Which of the following techniques should the phlebotomist use to insert a needle into a vessel in order to indicate the needle is in the vessel?

Advance the needle until a change in resistance is felt.

Advancing the needle until a change in resistance is felt indicates that the needle is in the vessel.

When performing a urine collection to test for a urinary tract infection, which of the following instructions should a phlebotomist provide to a patient?

"Start urinating, insert the collection cup into the urine stream, and fill with 30 to 100 mL of urine."

This is the correct instruction for a midstream collection.

Remember UTI is probably microbiology so sterile sample maybe?

Which of the following needles should a phlebotomist select to perform a venipuncture on a patient with fragile, easily collapsed veins? Allows for gentle control of suction to prevent vein collapse.

Straight needle and syringe

A straight needle with a syringe allows for gentle control of suction to prevent vein collapse.

On which of the following documents would a phlebotomist find information about the copayment amount for a patient who has a Medicare Advantage plan as their health insurance?

Insurance card

Copayment information is found on the patient's insurance card or by calling the phone number on the card.

Which of the following actions should a phlebotomist take when using a butterfly needle with a safety that is required to be engaged while in a patient's arm?

Cover the site with gauze after withdrawal.

Covering the site with gauze and then providing pressure helps stop bleeding.

Within which of the following time periods should a phlebotomist collect a newborn's screening test on a filter paper card?

Within 72 hr

The phlebotomist should collect the newborn screening test on a filter paper card within 72 hr of birth.

Which of the following personal protective equipment (PPE) provides a phlebotomist with the appropriate protection when collecting blood from a patient who has active tuberculosis?

N95 respirator

The CDC requires the phlebotomist to wear an N95 respirator when working with patients who have active tuberculosis. An N95 respirator eliminates all particles in the air that are larger than 0.3 microns.

Which of the following tests is known to be the most accurate for detecting if a patient has lactose intolerance?

Hydrogen breath test

A hydrogen breath test measures the amount of hydrogen exhaled to help identify problems with the digestion of carbohydrates such as lactose. It is the most accurate lactose tolerance test.

A provider adds an additional blood test at a patient's bedside after a phlebotomist has gathered supplies. Which of the following actions should the phlebotomist take?

Create a label using a permanent ink pen.

The phlebotomist should create a label using a permanent ink pen to adhere to the new blood collection tube.

A phlebotomist is new to a health care facility and is accessing the laboratory information system for the first time. Which of the following actions should the phlebotomist take to ensure system security?

Log out after using the system.

Logging out after use helps ensure that no one else logs in under the phlebotomist's name.

Which of the following actions should a phlebotomist take when a patient's hemoglobin test results indicate that levels are in the critical range?

Call the provider's office.

When a test result is outside of the expected reference range, the phlebotomist should phone or page the provider.

Which of the following actions should a phlebotomist take when performing a venipuncture to help reduce pathogens on the site chosen for insertion?

Scrub back and forth over the site.

To help reduce pathogens, the phlebotomist should scrub over the site.

Upon reviewing the electronic health record (EHR) of an infant who has a twin, a phlebotomist sees a requisition for an infant bilirubin blood collection. Which of the following actions should the phlebotomist take to confirm that the tests are going to be performed on the correct infant?

Verify with the infant's parent or guardian.

To properly identify the infant, the phlebotomist should verify with the parent or guardian.

A phlebotomist observes that the median cubital vein is deep in a patient's arm and the basilic vein is straight and on the surface. Which of the following methods should the phlebotomist use when performing the blood collection?

Collect from the median cubital vein at a 30° angle.

The median cubital is a deep vein, and deeper veins require an angle close to 30°.

A phlebotomist is performing a blood glucose test. Which of the following glucose levels should the phlebotomist identify as being outside the expected reference range?

200 mg/dL

A blood glucose level of 200 mg/dL is above the expected reference range of 70 to 126 mg/dL. The phlebotomist should immediately report this finding to the provider.

Which of the following instructions should a phlebotomist provide to a patient for a urine pregnancy test?

"Obtain the specimen shortly after awakening."

The levels for human chorionic gonadotropin (hCG) are highest right after waking from sleep.

A phlebotomist is collecting a specimen from an infant to test for phenylketonuria (PKU). Which of the following equipment should the phlebotomist use?

Screening card

The phlebotomist should use a newborn screening card to collect a specimen for neonatal screening, such as PKU.

Which of the following measures should be taken when the testing of an aliquoted sample for an autoimmune disease test will be processed 10 hr after collection?

Store the sample at 2° to 8° C (35° to 46° F).

To prevent inaccurate results, the sample should be refrigerated if it will be tested more than 8 hr after collection

Which of the following information is included on the chain of custody form after performing a venipuncture for forensic testing?

Location, date, and time of collection

Location, date, and time of collection is necessary for properly identifying the legal sample.

Which of the following actions should a phlebotomist take when a patient is bleeding profusely from an arm injury?

Apply pressure to the site.

Applying pressure will help stop or control the bleeding until help arrives.

Which of the following locations on an adult patient's body should a phlebotomist choose for a dermal puncture?

Side of the finger

The fleshy side of the finger is the best choice for a dermal puncture.

Which of the following compression rates should a phlebotomist use when performing CPR on a patient?

100 to 120 compressions/min

The compression rate when performing CPR on a patient should be 100 to 120 compressions/min.

A patient returns to an outpatient laboratory with blood dripping down their arm several minutes after a phlebotomist collected their blood. Which of the following postprocedural steps might the phlebotomist have omitted when collecting the patient's blood?

Checking the site to verify if bleeding has stopped

Verifying that bleeding has stopped will ensure that blood is not present on the surface and the vein wound.

A phlebotomist receives a chemical splash on their forearm. After removing their contaminated clothing, which of the following is the minimum amount of time the phlebotomist should rinse the affected area?

15 min

The phlebotomist should rinse the affected area for a minimum of 15 minutes after the contaminated clothing has been removed.

Upon insertion, a phlebotomist notices there is no blood in the tube, even though the needle appears to be in the vein. Which of the following conditions might have occurred?

The tourniquet is too tight.

A tourniquet that is too tight will reduce or stop blood flow to the vein.

A phlebotomist is preparing to collect a specimen for a blood alcohol concentration (BAC) test. Which of the following antiseptics should the phlebotomist use to clean the venipuncture site?

Povidone-iodine

The phlebotomist should use a nonalcoholic antiseptic, such as benzalkonium chloride or povidone iodine, when collecting a specimen for a BAC test. This prevents introducing alcohol into the specimen and affecting the test results.

Which of the following is the most important action to take before donning a respirator?

Confirm that the fit is correct.

A correctly fitted mask or respirator will help protect the phlebotomist from disease.

Which of the following procedures should a phlebotomist use to help promote an increase in the stability of a vein before insertion?

Place the thumb 2.5 to 5.1 cm (1 to 2 in) below the insertion site.

Placing the thumb 2.5 to 5.1 cm (1 to 2 in) below the site will help stabilize the vein for insertion.

A patient who has fragile veins has their blood collected via dermal puncture because they have a limit on the amount of blood that can be collected per day. Which of the following must be changed to help confirm that their private insurance will pay for the procedure?

ICD-10 code

The ICD-10 code needs to be updated from venipuncture to dermal puncture.

A phlebotomist opens a specimen tube in the laboratory and spills blood on the counter. Which of the following is the appropriate method for cleaning blood spills?

Using a 10% bleach solution

Blood or bodily fluids require a 1:10 dilution to be applied. Fresh bleach solutions should be made daily as needed.

A patient is sweating and hyperventilating. A phlebotomist asks if the patient is having any problems, and the patient states, "No." What action should the phlebotomist take?

Observe the patient and prepare for syncope.

Even though the patient has said they feel fine, it is important to be prepared to give aid.

Which of the following actions should a phlebotomist take when a patient's name on a requisition differs from the name on the patient's wristband?

Ask a nurse to confirm the patient's name on their wristband.

The phlebotomist should ask a nurse to confirm the patient's name on their wristband before performing a procedure. The phlebotomist should not perform a procedure without proper identification.

Which of these sections is a required component of Safety Data Sheets (SDS)?

Handling and storage

Handling and storage is a section of the SDS and describes the safe handling and storage of chemicals, including any incompatibilities.

Which of the following actions should a phlebotomist take when a patient states that they have sensitive skin and the only tourniquet available is made of latex?

Tie the tourniquet over the patient's clothing.

Tying the tourniquet over the patient's clothing helps keep the patient's skin away from the allergen.

A phlebotomist receives an order for a patient blood collection. After verifying their identity to the phlebotomist, the patient discloses to the phlebotomist that they had a bilateral mastectomy a year ago. Which of the following actions should the phlebotomist take?

Perform the collection only after obtaining written permission from the patient's provider.

The patient's provider must give written permission to collect blood from someone that has undergone a bilateral mastectomy.

A phlebotomist using tincture of iodine to cleanse a venipuncture site can adversely impact the results for which of the following tests?

Potassium

Even after tincture of iodine has dried, it can elevate potassium, phosphorus, and uric acid levels.

Which of the following actions should a phlebotomist take to help confirm that a patient who has difficulty hearing understands the explanation of a venipuncture?

Write out the procedural steps for the patient.

Writing out the procedural steps helps confirm that the patient understands the explanation.

During donor blood collection, a collection bag only fills halfway and the vein collapses. Which of the following actions should a phlebotomist take?

Use a new collection bag to collect a new unit of blood.

The phlebotomist should use a new collection bag to collect a new unit of blood. The phlebotomist should take this action because collection bags have a specific amount of the additive citrate phosphate dextrose to prevent coagulation.

A phlebotomist is preparing to collect a blood specimen from a patient who has HIV. Which of the following actions should the phlebotomist take?

Perform the venipuncture using standard precautions.

After donning gloves, the phlebotomist should perform the venipuncture for the patient who has HIV. Standard precautions should be followed for all specimen collections, according to the CDC.

A phlebotomist is preparing to call a patient after a glucose test was rejected by the laboratory. Which of the following statements should the phlebotomist make to the patient to help ensure an accurate result on glucose tests?

"Please refrain from eating or drinking for 9 hours before the test." 8-12

Fasting is one of the important ways to ensure accurate glucose test results.

Which of the following are in the correct order of collection for a dermal puncture?

EDTA, green, and red

EDTA, green-top tube, and red-top tube are in the correct order of collection. Collecting EDTA first helps reduce the negative impact on blood cells.

Microcollection order of draw

1. Blood Gases

2. EDTA (Lavender)

3. Heparinized tubes (Green)

4. Other Additive Tubes

5. Red (nonadditive)

After which of the following glucose readings should a phlebotomist be required to run controls on a glucometer after testing a patient's glucose?

A glucose reading of 20 mg/dL after the patient ate breakfast

Ref range: 70-120 or something

Any unexpected reading on a glucometer calls for quality controls testing to be repeated.

Which of the following actions should a phlebotomist take to assist in filling a donor collection bag?

Place the bag below the donor's arm.

Placing the bag below the donor's arm will allow gravity to help fill the collection bag.

Which of the following should a phlebotomist evaluate to identify if a glucometer is meeting thresholds?

Quality controls

Quality controls involves determining if a glucometer is meeting the minimum level or threshold

Which of the following actions should a phlebotomist take to help ensure that a capillary tube will produce an accurate sample?

Hold the capillary tube horizontally for collection.

Holding the capillary tube horizontally will help encourage a completely full sample.

Which of the following results might occur when an expired EDTA tube is used during a venipuncture?

The sample might clot.

If the additive in the EDTA tube has expired, it might not be able to stop the sample from clotting.

Which of the following measures should a phlebotomist take before entering a patient's room with a sign indicating that droplet precautions are required?

Don a mask.

A mask is the recommended personal protective equipment (PPE) when there is a chance for droplet transmission from talking, coughing, or sneezing.

Which of the following statements should a phlebotomist make when a patient states they are anxious about venipuncture?

"Do you have any questions?"

Allowing time for questions allows the patient to express any concerns.

A phlebotomist is performing a venipuncture when a patient experiences cardiac arrest. After discontinuing the procedure, which of the following actions should the phlebotomist take?

Perform chest compressions.

The American Heart Association (AHA) stresses the need for chest compressions for victims of sudden cardiac arrest.

Which of the following is required to help phlebotomists understand the exposure risks of venipuncture and dermal puncture?

Bloodborne pathogen training

Bloodborne pathogen training is required for all personnel to understand the risks of blood exposure.

After a phlebotomist performs a heel puncture for neonatal screening, which of the following is the correct procedure for collecting the blood?

Saturate each circle with one drop of blood.

When performing a heel puncture, the phlebotomist should wipe away the first drop of blood, saturate each circle with one drop, and allow it to dry for 4 hr.

Which of the following tubes should be chosen to collect a blood alcohol concentration (BAC) test?

Sodium fluoride

A gray glass sodium fluoride tube should be used to collect a BAC test.

A phlebotomist is preparing to collect a blood specimen from a patient who has an allergy to alcohol. Which of the following antiseptic solutions should the phlebotomist use to prepare the insertion site?

Chlorhexidine

The phlebotomist should apply chlorhexidine to the insertion site. Chlorhexidine is an alternative antiseptic solution for patients who have allergies to alcohol or latex.

A phlebotomist is preparing to perform a dermal puncture test for HIV on a patient. Which of the following information should the phlebotomist provide to the patient before obtaining consent?

What will be done with the test information

The patient has the right to know what will be done with their test information.

Which of the following statements should a phlebotomist make to another health care professional who is performing a second blood culture collection on a patient?

"I performed the venipuncture on the right arm."

The phlebotomist should tell the second health care professional the location of the first collection site because it is best to perform the second collection at a different site.

Which of the following actions should a phlebotomist take when using a butterfly needle to perform a venipuncture on a deep vein in a patient's hand?

Insert the butterfly needle distally into the chosen vein.

Inserting from below the vein helps provide the best chance of success.

A phlebotomist performing a venipuncture chooses pink-top tubes for a crossmatch that was ordered. Which of the following departments should receive the test results?

Immunohematology/blood bank

A crossmatch is typically evaluated by the immunohematology/blood bank department.

Which of the following antiseptics would help ensure accurate results when performing a blood collection test for blood alcohol testing?

Aqueous benzalkonium chloride

Aqueous benzalkonium chloride is an alcohol-free antiseptic that may be used when performing blood alcohol testing.

Which of the following actions should a phlebotomist take when assisting in the collection of a nasopharyngeal sample for COVID-19 from a patient?

Rotate a swab in the nasal cavity four times.

Rotating a swab in the nasal cavity four times helps gather enough sample material for accurate testing.

A phlebotomist is preparing to ship blood specimens to an out-of-the-area laboratory. Which of the following actions should the phlebotomist take?

Ensure ice is used for transporting blood specimens.

Ice or dry ice must be used to ship blood specimens.

After exiting a patient's room, which of the following is the last piece of personal protective equipment (PPE) that a phlebotomist should remove?

Mask

When removing PPE, the phlebotomist should first remove the gloves, then the goggles, and then the gown. The mask is the last piece of PPE the phlebotomist should remove after exiting the patient's room.

A phlebotomist obtains two readings of 17 mg/dL (70 to 100 mg/dL) when checking a patient's glucose level. Which of the following actions should the phlebotomist take?

Perform a set of liquid controls.

The phlebotomist should perform quality control testing to verify that the glucometer is working correctly.

Which of the following actions should a phlebotomist take when collecting multiple evacuated tube system (ETS) tubes for venipuncture?

Sequencing

The order of draw is performed in sequential order.

At which of the following temperatures should a phlebotomist transport a semen sample?

36° to 38° C (96.8° to 100.4° F)

The phlebotomist should identify that semen samples should be kept warm, stored, and transported at 37° C (98.6° F).

A phlebotomist is instructing a patient about how to collect a fecal occult specimen. Which of the following instructions should the phlebotomist include?

Urinate prior to collecting the specimen.

The patient should avoid getting urine in the fecal specimen to prevent adversely affecting the sample.

For which of the following reasons should a phlebotomist centrifuge a serum specimen before transport to an outside reference laboratory?

Blood cells must be separated from the serum.

If the specimen is not centrifuged, the blood cells will continue to metabolize into the serum. Therefore, the phlebotomist should centrifuge a serum specimen before transporting it to a laboratory.

A phlebotomist is performing a heel stick for a phenylketonuria (PKU) screening of a newborn. After identifying the newborn, performing hand hygiene, and putting on gloves, which of the following actions should the phlebotomist take?

Wrap the foot in a warm, wet towel or a heel warming pack.

Warming the heel prior to sticking with a lancet will allow blood to flow easily.

Which of the following actions should a phlebotomist take when preparing to centrifuge a STAT blood collection of one 8-mL tube and two 6-mL tubes?

Prepare a tube with 8 mL of water.

Preparing a water tube will help balance the centrifuge, allowing for rapid turnaround.

A phlebotomist prepares to perform a blood collection on a patient in a wheelchair. Which of the following actions should the phlebotomist take to help ensure patient safety?

Lock the brakes on the wheelchair.

Locking the brakes when performing a blood collection will keep the patient from accidentally moving.

Which of the following preparations for the transportation of an evacuated tube system (ETS) specimen will provide the most accurate test results?

Place the tubes stopper-side up in a leakproof container to avoid saturation.

The tubes should be placed stopper-side up for shipping.

Which of the following actions should a phlebotomist take to prepare the venipuncture site for collecting a unit of blood from a donor?

Use a chlorhexidine foam-head applicator to prepare the site.

Using a chlorhexidine foam-head applicator to prepare the site is one of the recommended antiseptics for donor blood collection.

Which of the following statements by a phlebotomist regarding skin preparation for blood cultures is appropriate?

"I will cleanse the area with chlorhexidine gluconate."

Due to an increase in iodine sensitivity, health care facilities are using chlorhexidine gluconate in an isopropyl alcohol solution when performing skin preparation for blood cultures.

Which of the following temperature ranges should be maintained for a room temperature point-of-care test?

20° to 30° C (68° to 86° F)

This is the temperature range for room temperature.

A phlebotomist is about to enter the room of a patient who has tuberculosis. Which of the following types of precautions should the phlebotomist follow?

Airborne precautions

Microorganisms are transmitted by airborne droplets. Since tuberculosis is airborne, airborne precautions need to be followed.

Which of the following is a requirement of the Needlestick Safety and Prevention Act?

Sharps injury log

New record-keeping requirements under the Needlestick Safety and Prevention Act include the requirement to keep a sharps injury log.

A phlebotomist is collecting a urine specimen from a patient for a pre-employment drug screening. Which of the following actions should the phlebotomist take?

Ensure the specimen is within a temperature range of 32° to 38° C (90° to 100° F).

The phlebotomist should ensure that the specimen is within a temperature range of 32° to 38° C (90° to 100° F).

Prior to a patient's venipuncture, it is determined that there is a $25 copay. The patient is nervous about the blood collection and wants to start immediately. Which of the following measures should be taken?

Collect the copay before the procedure.

When a copay is necessary, it should be collected before the procedure.

A patient is given a container for collecting a sputum specimen at home. Which of the following instructions for collecting the sputum specimen should be given to the patient?

"The specimen collection needs to be performed first thing in the morning."

The best sample for analysis is collected prior to the patient having anything to eat or drink.

Which of the following insurance information should a phlebotomist check to confirm that a requisition form is filled out completely?

The ICD-10 code

The phlebotomist should confirm that the most updated diagnostic code is recorded on the requisition.

Blood cultures have been ordered for an adult patient in an intensive care unit. A nurse calls a phlebotomist to bring the appropriate materials for blood collection. Which of the following materials should the phlebotomist bring?

An aerobic bottle and an anaerobic bottle

​The phlebotomist should bring a set that contains an aerobic and an anaerobic bottle.

Which of the following actions should a phlebotomist take to help ensure an accurate hematocrit test result?

Seal one end of the tube after collection.

Sealing the tube after collection will help retain the blood for centrifugation.

When applying a label containing a bar code, which of the following actions are important for a phlebotomist to take to help ensure that the bar codes will be easily read by the bar code scanner?

Smooth the label to ensure that there are no wrinkles.

A wrinkle in the label might make it difficult for the scanner to read the bar code accurately.

Which of the following actions is part of the postexamination phase of the Clinical and Laboratory Standards Institute's (CLSI) clinical laboratory workflow pathway?

Entering laboratory data

Entering laboratory data is part of the postexamination phase of the CLSI clinical laboratory workflow pathway.

Which of the following instructions should a phlebotomist give to a patient to prepare for a 2-hr postprandial collection?

"Do not smoke or chew gum for a minimum of 10 hours before the test."

To help provide accurate test results, the patient should avoid smoking or chewing gum for a minimum of 10 hr prior to the test.

A phlebotomist is preparing to store a blood specimen. At which of the following temperatures should the phlebotomist store the specimen?

2° to 8° C (35.6° to 46.4° F)

The phlebotomist should store the blood specimens refrigerated at 2° to 8° C (35.6° to 46.4° F).

Which of the following antiseptics would be considered an acceptable choice for cleansing nonsoiled hands between patients?

60% alcohol

The CDC recommends using 60% alcohol when hands are not visibly soiled.

A patient is concerned about their test results. Which of the following people should access the laboratory information system to determine the status of the test results?

The laboratory clerk

The laboratory clerk or nurse can access the laboratory information system to determine the status of the test results.

A patient asks a phlebotomist for their results after a point-of-care glucose test. Which of the following statements should the phlebotomist make to the patient?

"Your glucose reading was 97."

Point-of-care testing (POCT) brings the laboratory testing to the patient with a short turnaround time, enabling the phlebotomist to provide the glucose test results to the patient right away after conducting the POCT.

Which of the following actions should a phlebotomist take to help ensure the complete filling of a filter paper card test?

Squeeze gently to produce a large drop of blood.

A large drop of blood will help fill the card completely and avoid blood overlapping in the circle on the filter paper.

Which of the following actions should a phlebotomist take to help ensure accurate test results when a plastic serum tube for electrolytes has been collected?

Invert the tube immediately after collection.

Inverting the tube immediately after collection allows the clot activator to act on the sample.

After verifying a patient's identity, the phlebotomist sees that the patient's laboratory results are ready. Which of the following actions should the phlebotomist take?

Inform the patient to contact the ordering provider to obtain the results.

Only the ordering provider can discuss laboratory results with the patient. The phlebotomist should instruct the patient to contact the provider to obtain the laboratory results.

Which of the following is the basis for choosing the correct tube color and additive?

Laboratory test

​Each tube color is collected for a designated test.

Which of the following personal protective equipment (PPE) should be worn when aliquoting a sample from a patient who has pneumonia?

Goggles or face shield and mask

Wear goggles or a face shield and a mask whenever a splash is possible.

A phlebotomist notices excessive swelling at a patient's insertion site. The phlebotomist removes the tourniquet and the needle from the patient. Which of the following is a contributing factor to the excessive swelling?

The phlebotomist was probing for the vein.

The movement of the needle can create pain for the patient and result in enlarging the hole in the vein, causing leakage of blood and swelling at the site.

In which of the following ways should a phlebotomist assist another health care professional who is performing a venipuncture with a syringe?

Transfer the blood with a syringe transfer device.

Transferring blood quickly into vacuum tubes helps ensure accurate test results, and it is safe for the phlebotomist to assist.

Which of the following correctly identifies when a phlebotomist should perform external quality controls on a CLIA-waived glucose point-of-care test?

When batteries are replaced

The phlebotomist should perform external quality controls when batteries are replaced on the device.