Exam practice

1. Which of the following methods of reporting results by a clinical laboratory abides by the recommended standards set by the joint commission?
a) An emailed report from the clinical lab tech to the patient
b) An in-person report from the clinical lab tech to the nurse
c) A called-in report from the clinical lab tech to the phlebotomist
d) A faxed report from the clinical lab tech to the physician

D

2. The results from which of the following tests are an example of point of care testing?
a) A positive HIV test
b) An elevated sweat chloride test
c) A positive hepatitis test
d) An elevated blood glucose test

D

3. Which of the following is caused by excessive shaking of a tube?
a) Hemostasis
b) Hemoconcentration
c) Hemolysis
d) Hemophilia

C

4. Which of the following methods proves the most secure and reliable delivery of lab results?
a) Fax
b) Electronic reports
c) Verbal reports
d) Courier delivery

B

5. A phlebotomist has just confirmed critical values on a lab test. which of the following actions should the phlebotomist take when the physician's office is already closed?
a) Leave a message at the physician's office number
b) Contact the physician by paging or calling right away
c) Call the physician's office on the next business day
d) Fax the results to the physician's office with stat fax cover

B

6. Utilizing tubes that have expired may result in which of the following?
a) Hemolysis
b) Hemoconcentration
c) Elevation of the red blood cell count
d) Loss of vacuum

D

7. Which of the following blood components is needed for hemostasis to take place?
a) Erythrocytes
b) Neutrophils
c) Leukocytes
d) Thrombocytes

D

8. Which of the following processes occurs after a venipuncture to control the bleeding?
a) Hemoconcentration
b) Homeostasis
c) Hematopoiesis
d) Hemostasis

D

9. A phlebotomist has washed their hands for a venipuncture. Which of the following actions should the phlebotomist take to dry their hands?
a) Dry hands with sterile towel
b) Dry hands with the sanitizing hand gel
c) Dry hands with disposal sanitizing cloth
d) Dry hands with a clean disposable towel

D

10. Fasting specimens are preferred for which of the following tests?
a) Creatinine
b) Cholesterol
c) Pregnancy
d) Thyroid

B

11. A phlebotomist is instructing a patient on how to collect a stool specimen. Which of the following instructions should the phlebotomist give the patient about the collection procedure?
a) "label the lid of the container"
b) "wear sterile gloves during collection"
c) "avoid urine contact with specimen"
d) "refrigerate the specimen after collection"

C

12. Which of the following needles should the phlebotomist use for a venipuncture using a winged infusion set and a 5 ml syringe?
a) 27-gauge
b) 23-gauge
c) 18-gauge
d) 25-gauge

B

13. A patient is on contact precautions. What PPE, other than the standard gloves, would be required?
a) Surgical mask
b) Face shield or goggles
c) Gown
d) N95 mask

C

14. Which of the following is an appropriate technique for specimen collection?
a) Performing a thumb stick on an infant
b) Performing a thumb stick on a 5-year old patient
c) Performing a finger stick on a toddler patient
d) Performing a heel stick on a 5-year old patient

C

15. According to the CLSI, the standard depth of a dermal puncture for an infant is?
a) 3 mm
b) 2 mm
c) 0.20 mm
d) 0.30 mm

B

16. The Clinical Laboratory Standards Institute recommends a heel lancet penetration be less then 2 mm to prevent which of the following conditions?
a) Tissue fluid contamination
b) Bone penetration
c) Pain
d) Excessive bleeding

B

17. Failure to demonstrate proper care that results in an injury to another person is an example of what?
a) Assault
b) Negligence
c) Fraud
d) Battery

B

18. A large spill has occurred in a lab involving venous blood. which of the following actions should the phlebotomist take?
a) Evacuate the lab
b) Apply a liquid thickening agent on top of the spill
c) Pour bleach on the spill and let it soak for 60 seconds
d) Cover the spill until maintenance arrives

C

19. A phlebotomy tech is concerned that the office's current butterfly needles are not up to safety standards. Which of the following agencies can confirm safety compliance of the equipment for the tech?
a) American Society for Clinical Laboratory Sciences
b) National Institute of Health
c) CDC
d) OSHA

C

20. Drawing a patient's blood without consent can result in a charge of?
a) Battery
b) Negligence
c) Malpractice
d) Breach of contract

A

21. Which of the following best exemplifies diversity awareness in the workplace?
a) Acknowledging patient's beliefs and customs
b) Acknowledging patient's hobbies and interests
c) Acknowledging presence of patient's family and friends
d) Acknowledging patient's questions and complaints

A

22. Which of the following blood specimen tests are photosensitive and should be protected from light?
a) Gastrin
b) Pyruvate
c) Ammonia
d) Bilirubin

D

23. A phlebotomist is processing a urine specimen in the lab. Which of the following personal protective equipment is required to maintain safety regulations in the lab?
a) Shoe covers
b) Surgical gloves
c) Face shield
d) Hairnet

C

24. A phlebotomist is planning to collect a specimen to measure a patient's serum cortisol level. Which of the following factors should the phlebotomist consider?
a) Body temperature
b) Prandial status
c) Time of day
d) Alcohol consumption

C

25. Which of the following is the correct location to anchor a vein before performing a venipuncture?
a) 1 to 2 inches medial to the puncture site
b) 3 to 4 inches lateral to the puncture site
c) 3 to 4 inches above the puncture site
d) 1 to 2 inches below the puncture site

D

26. Which of the following actions should a phlebotomist tech take when a patient has a seizure during the collection?
a) Restrain the patient
b) Complete the blood collection
c) Use a tongue depressor to hold patient's tongue down
d) Move the patient to the floor

D

27. Every state in the U.S requires that a newborn be tested for which of the following?
a) Bacteremia
b) Septicemia
c) Phenylketonuria
d) Proteinuria

C

28. Which of the following is the general concept behind standard precautions?
a) Ensure that employees receive training regarding workplace hazards
b) Provide information about hazardous chemicals to the environment within
c) Maintain a workplace that is free of environmental hazards
d) Assume that all body fluids are infected with bloodborne pathogens

D

29. After cleaning the collection site with an antiseptic agent, the phlebotomist should do which of the following?
a) Dry the site by fanning it
b) Allow to air dry
c) Wipe the site dry with a piece of sterile gauze
d) Blot the site dry using a piece of sterile gauze

B

30. Which of the following actions is required immediately after a phlebotomist experiences an accidental needle stick injury?
a) Send the patient for further STI testing
b) Save the collection device for further evaluations
c) Report the exposure to the CDC
d) Report to a supervisor

D

31. Which of the following is used to stabilize a patient's arm during a venipuncture?
a) A blood pressure cuff
b) A phlebotomy cart
c) Arm restraints
d) A phlebotomy wedge

D

32. Which of the following actions should a phlebotomist take next for an adult capillary puncture after sanitizing and puncturing the site?
a) Firmly squeeze the site until the desired tube filled
b) Wipe away the first drop of blood
c) Collect the specimen with the capillary tube inverted 30-degree angle
d) Wait for 30 seconds until the site has produced enough blood to collect

B

33. If a patient is on droplet precautions, the phlebotomist should recognize that which of the following would be a means of transmission?
a) The patient provides a urine specimen
b) The patient had a bloody nose
c) The patient reports an itchy rash
d) The patient sneezes

D

34. Which of the following refers to the process of cleaning up a blood specimen spill on a counter?
a) Disinfection
b) Neutralization
c) Containment
d) Sterilization

C

35. Which of the following nonverbal factors can have a POSITIVE impact when phlebotomist introduce themselves to patients?
a) Take a position facing a patient
b) Avoid direct eye contact with a patient
c) Keep arms crossed while talking to a patient
d) Remain standing while patient is sitting

A

36. A phlebotomist inserts a needle into a patient's vein and observes no blood flow into the tube. Which of the following actions should the phlebotomist take?
a) Reposition the needle to 90 degrees
b) Remove the needle
c) Laterally redirect the needle
d) Pull needle back slightly

D

37. A phlebotomist is preparing to collect a capillary blood specimen using the aseptic technique. Which of the following cleaning agents should the phlebotomist use?
a) 10% chlorine bleach solution
b) Provide-iodine
c) 70% isopropyl alcohol
d) Hand sanitizer

C

38. If a tube is not inverted correctly after collection. It may cause
a) False test results
b) Hemoconcentration
c) A failure in the centrifugation process
d) Cell dilution

A

39. Which of the following governing bodies mandates the use of safety features on needles immediate disposal as one unit in the biohazard container?
a) OSHA
b) CDC
c) HIPPA
d) CLIA

B

40. How can a phlebotomist distinguish whether a collection tube contains serum or plasma?
a) EDTA in the collection tube indicates plasma
b) SST in the collection tube indicates plasma
c) Sodium citrate in the collection tube indicates serum
d) Sodium fluoride in the collection tube indicates serum

A

41. A phlebotomist should administer CPR to which of the following patients?
a) A patient who is lethargic
b) A patient who is pulseless
c) A patient who has chest pain
d) A patient who is short of breath

B

42. A phlebotomist should instruct a patient to take which of the following actions when providing a sputum specimen?
a) Aggressively swab the inside of the cheek
b) Collect the stool directly into a sterile container
c) Take a deep breath and then expectorate
d) Discard the first urine of the day and collect 24 hr.

C

43. Which of the following color top tubes will the phlebotomist need to perform a A1C, CBC, hepatic panel?
a) Red and black
b) Green and gray
c) Gold and lavender
d) Yellow and blue

C

44. How many times should an EDTA tube be inverted after blood collection?
a) 1 to 3
b) 5 to 7
c) 2 to 4
d) 8 to 10

D

45. An adult patient gives implied consent to phlebotomist when which of the following occurs?
a) When the patient signs a document of agreement for a research study
b) When the patient offers their arm out to the phlebotomist
c) When the patient's family member nods for the phlebotomist to proceed
d) When the patient signs a release for their lab results

B

46. An 8-year-old patient arrives at the lab for blood work. Which of the following information is required on the venipuncture request?
a) Guardian's name and date or birth
b) Lab accreditation number
c) Requesting providers name
d) Phlebotomy tech name

C

47. Which of the following actions should a phlebotomist take to comply with guidelines for a CLIA waived procedure?
a) Report results immediately to CLIA
b) Document quality control agents
c) Transport specimens within 24 hours
d) Process the specimen within one hour of collection

B

48. Which of the following types of bleeding should a phlebotomist notify a provider or a nurse of?
a) Subcutaneous
b) Arterial
c) Venous
d) Capillary

B

49. A phlebotomist should identify which of the following as the best site for phenylketonuria collection on an infant?
a) The central area of the fingertip
b) The medial or lateral areas of the heel
c) The central area for the heel
d) The medial or lateral of the fingertip

B

50. A lab is scheduled for a routine annual inspection with the primary focus on the equipment maintenance logs. Which of the following areas will be the focus of the inspection?
a) Mechanical safety
b) Radiation safety
c) Electrical safety
d) Chemical safety

A

51. Which of the following parameters should a phlebotomist consider when selecting a collection method?
a) Time of day, timing of specimen, test status
b) Patient height, patient gender, patient medication
c) Patient condition, patient age, blood volume required
d) Ordering physician, number of tests ordered, diagnosis

C

52. A phlebotomist enters a patient's room and observes the patient to be motionless and cyanotic. Which of the following actions should the phlebotomist take first?
a) Ask the patient if they are okay in a loud voice?
b) Perform the heel-tilt/chin-lift maneuver
c) Look, listen, and feel for breathing movements
d) Administer two rescue breaths

C

53. A phlebotomist should identify that a blood spot collection for inborn errors of metabolism requires
a) The newborn must be at least 3 days old
b) The specimen must be completely dried before the test can be processed
c) The first drop of blood immediately following the picture must be included
d) The circles on the filter paper must be at least half full

B

54. When performing a test for a PKU, the specimen should be processed using which of the
following?
a) Transfer device
b) Capillary tube
c) Filter paper
d) Microtainer

C

55. Which of the following criteria is acceptable in determining the quality of a peripheral blood smear?
a) Covers the entire slide
b) A feathered edge
c) Covers a quarter of the slide
d) A well-defined edge

B

56. A phlebotomist allows another administrative employee to use their login password to enter a patient's laboratory results. Which of the following regulates the confidentiality that has been breached in this situation?
a) FDA
b) OSHA
c) CLIA
d) HIPPA

D

57. Which of the following lancet positions should a phlebotomist use for a capillary blood collection on a healthy adult patient?
a) Parallel to the nail bed
b) Perpendicular to the fingerprint grooves
c) Along the medial portion of the fifth finger
d) Along the lateral portion of the first digit

B

58. If a phlebotomist's hands are visibly soiled with blood or body fluids what should the tech use to clean them?
a) Soap and water
b) Alcohol rinse
c) Alcohol based hand rub
d) Sterile water rinse

A

59. Which of the following techniques of needle insertion into the antecubital space is in accordance with suggested venipuncture guidelines?
a) With the bevel facing down at an angle of 25 degrees
b) With the bevel facing up at and angle of 15 to 30 degrees
c) Parallel to the vein at an angle of 35 degrees
d) Perpendicular to the vein at an angle of 30 to 45 degrees

B

60. Which of the following actions should a phlebotomist take for a patient who has had a recent double mastectomy?
a) Elevate each arm and draw from the most acceptable distal vein in either arm
b) Contact the ordering provider and obtain permission to draw from either of the arms
c) Evaluate each arm and draw only from the arm with minimal inflammation
d) Proceed without modification since the mastectomy was bilateral

B

61. When performing a dermal puncture on a patient 1 year of age and older, the phlebotomist should place the lancet in which of the following locations?
a) The thumb
b) Middle (3rd) finger
c) Index (2nd) finger
d) Pinky (5th finger)

B

62. A phlebotomist is preparing a blood smear slide. Which of the following actions should the phlebotomist take before transporting the specimen?
a) Use a sterile gauze to gently dry the smear
b) Allow the smear to air dry
c) Place smear in the freezer to dry
d) Blow air on the smear to dry it

B

63. Which of the following pieces of information is a phlebotomist required to include on the label of a blood specimen tube?
a) Patient's phone number
b) Laboratory's address
c) Phlebotomist's initials
d) Provider's NPI number

C

64. A phlebotomist is preparing to collect a blood specimen from a patient who has self-reported needle phobia. Which of the following actions should the phlebotomist take?
a) Encourage the patient to chew gum during the procedure
b) Place the patient's elbow joint in 90 degree of flexion
c) Instruct the patient to lie supine during the procedure
d) Warm the site for 10 mins before venipuncture

C

65. Following the collection of the last specimen collection tube. Which of the following actions should the phlebotomist take next?
a) Withdraw the collection needle from the vein
b) Place the used needle in biohazardous receptacle
c) Hold gauze firmly over the insertion site
d) Disengage the tube from the collection tube

D

66. Which of the following pairs of blood tests is appropriate for a fasting specimen?
a) BUN and alkaline phosphatase
b) Glucose and triglycerides
c) Creatinine and total protein
d) Lactate dehydrogenase and albumin

B

67. While performing donor phlebotomy for a blood bank, the phlebotomist should use a
a) 21- to 22-gauge needle
b) 12- to 14- gauge needle
c) 23- to 25- gauge needle
d) 16- to 18- gauge needle

D

68. Which of the following is a phlebotomist required to document on a CBC specimen label?
a) Patient's identification number
b) Patient's insurance provider name
c) Phlebotomist's full name
d) Phlebotomist certification number

A

69. The duties of a phlebotomist include
a) Evaluating stained blood smears
b) Calibrating instruments within the lab
c) Establishing test protocols for specimen analysis
d) Greeting and instructing patients

D

70. A phlebotomist should recognize that proper hand hygiene can result in which of the following?
a) An increase in the accuracy of lab results
b) And increase in the potential sources of pathogens
c) A decrease in the rejection of lab specimens
d) A decrease in the incidence of health care-associated infections

D

71. Which of the following is the vein of choice for a venipuncture procedure?
a) Radial
b) Cephalic
c) Median cubical
d) Median basilic

C

72. When drawing blood on a preschooler, the phlebotomist should
a) Explain the procedure to the parent and child
b) Not tell the child when the needle insertion is coming
c) Obtain a thumb stick
d) Obtain a heel stick

A

73. A phlebotomist is preparing to obtain an inpatient specimen from a patient. Which of the following locations is the proper place for the phlebotomist to place the tourniquet?
a) Over the patient's weeping rash
b) Above the patient's iv site
c) Over the patient's gown sleeve
d) On top of the patient's burn wound

C

74. If no vein is apparent on first inspection which of the following actions should the phlebotomist tech take before reapplying the tourniquet?
a) Apply an ice pack to the patient's arm
b) Tell the patient to pump their fist rapidly
c) Have the patient rest their arm in a downward position
d) Tap repeatedly on the patient's arm

C

75. Which of the following practices should a phlebotomist follow to help monitor the volumes of blood collected in pediatric patients?
a) Limit the collection of blood from a patient to three times per day
b) Obtain a stat prescription before drawing blood
c) Maintain an updated log of blood collected from patients
d) Use patients' armbands to identify restrictions on blood draw volume

C

76. Which of the following forms commonly accompanies a toxicology drug screen for legal purposes?
a) Encounter
b) CMS 1500
c) Requisition
d) Chain of custody

D

77. A phlebotomist is preparing to draw blood from a patient for therapeutic drug monitoring. Which of the following questions should the phlebotomist ask?
a) "when did you have your last alcoholic beverage?"
b) "have your finished drinking the glucose solution?"
c) "for how long you have been fasting?"
d) "when was your last dose of lithium?"

D

78. A phlebotomist finds a patient who is unresponsive and not breathing. In which of the following positions should the phlebotomist place the patient before initialing CPR?
a) Supine
b) Prone
c) Semi-fowler's
d) Side-lying

A

79. According to the CLSI order of draw guidelines, which of the following samples should the phlebotomist collect first?
a) Electrolytes
b) Glucose
c) Cultures
d) Coagulation

C

80. Which of the following actions should a phlebotomist take when using a tourniquet?
a) Tie a knot with the tourniquet that will not slip
b) Release the tourniquet with one hand
c) Position the tourniquet 3 to 4 inches below the site
d) Wash the tourniquet with soap and water after use

B

81. A phlebotomist is obtaining a venipuncture specimen and has decided to use the vein which lies on the outer edge of the arm. Which of the following veins has the phlebotomist selected?
a) Basilic
b) Dorsal
c) Median cubical
d) Cephalic

D

82. How should a phlebotomist instruct a female patient to collect a urine specimen for culture testing?
a) Do not touch the inside of the container, clean the urinary meatus from the back to the front, and then collect the specimen
b) Do not touch the inside of the container, clean the urinary meatus from back to front. begin voiding in toilet, and then collect the specimen
c) Do not touch the inside of the container, clean the urinary meatus from front to back, begin voiding in toilet, and then collect the specimen
d) Do not touch the inside of the container, clean the urinary meatus from front to back and then collect the specimen.

C

83. When preparing to explain a phlebotomy procedure to a patient. Which of the following actions should the phlebotomist take?
a) Ensure that medical terminology is used in the explanation
b) Plan to use empathy toward the patient during the discussion
c) Remain in a standing position while the patient sits in a chair
d) Plan to communicate while in the patient's intimate personal space

B

84. A phlebotomist has duplicate orders for a patient. How should the order be verified?
a) determine which requisition matches with the patient's previous test requisitions
b) call the provider to confirm the test requisition for the patient
c) confirm with the patient what lab work the provider prescribed
d) draw both orders and discard the incorrect specimen

B

85. a phlebotomist is required to use the sharps container to dispose of which of the following items after performing a capillary collection?
a) Used gauze
b) Microtainer tube
c) Alcohol wipe
d) Lancet

D

86. A report of lab results is required to have which of the following information?
a) Values of previous tests
b) Phlebotomist's initials
c) Patient diagnosis
d) Date of specimen collection

D

87. Which of the following information must a phlebotomist include on the label of a venipuncture specimen?
a) Time of venipuncture
b) Ordering provider's NPI number
c) Location of the venipuncture
d) Phlebotomist's credentials

A

88. A phlebotomist should use a blood transfer device with which of the following methods of blood collection?
a) Syringe
b) Capillary puncture
c) Winged infusion
d) Evacuated tube system

A

89. A phlebotomist is obtaining a blood specimen from a patient who is suspected of having mycobacterium tuberculosis infection. Which of the following pieces of equipment is required?
a) Nonlatex tourniquet
b) N95 respirator
c) Face shield
d) Sterile gloves

B

90. There has been a chemical spill in the lab. To which of the following should a phlebotomist refer for directions to clean up the spill?
a) OSHA
b) CLIA
c) SDS
d) CDC

C

91. After centrifuging, a green top tube yields a specimen of
a) Clotted blood
b) Plasma
c) Whole blood
d) Serum

B

92. Which of the following is required on a chain of custody form after a urine drug screen?
a) Patient's signature
b) Patient's insurance number
c) Provider's signature
d) Diagnosis code

A

93. A phlebotomist has entered incorrect information in a patient's paper chart after a venipuncture procedure. Which of the following actions should the phlebotomist take to correct the error?
a) Notify the provider about the error
b) Erase the error and correct information
c) Strike a line through the error and initial
d) Ask an administrator to erase the error and input the correct information

C

94. Which of the following actions should a phlebotomist take after collecting blood into a serum separation tube?
a) Roll the tube five to ten times
b) Shake the tube vigorously five to eight times
c) Invert the tube five to eight times
d) Invert the tube three to four times

C

95. Which of the following tests is performed to identify bacteremia?
a) Glucose tolerance test
b) Peripheral blood smear
c) Blood culture
d) Lactic acid

C

96. Aseptic techniques are followed by phlebotomists during phlebotomy procedures for which of the following reasons?
a) To decrease the risk of infection to patients and phlebotomists
b) To minimize the volume of the blood sample required
c) To maintain the stability of patient specimens
d) To increase the likelihood of successful collection

A

97. A phlebotomist experiences a needlestick injury and discusses the event with the patient's partner without the patient's permission. The phlebotomist is now in violation of which of the following?
a) The joint commission
b) OSHA
c) HIPPA
d) Needlestick Safety and Prevention Act

C

98. Which of the following is the appropriate procedure for handling an ammonia specimen?
a) Transport in warm water
b) Transport on ice
c) Protect from light
d) Protect from diurnal variation

B

99. A phlebotomist should collect which of the following equipment for an ordered comprehensive metabolic panel (CMP)?
a)
b) Lancets, microhematocrit tubes, clay sealant
c) Sterile cup, reagent strip, disinfectant towelette
d) Tourniquet, multi-sample needle, collection tube
e) Aerobic culture bottle, anaerobic culture bottle, chlorhexidine swab

D

100. Which of the following anticoagulants is found in lavender-topped blood collection vacuum tube?
a. Lithium heparin
b. Sodium citrate
c. EDTA
d. Sodium heparin

C