NATIONAL ACADEMY

PHLEBOTOMY FINAL EXAM

NAME: _______________________________

DATE: _______________________________

PAPER 1

TIME: 1: 15 MINS
80 MULTIPLE CHOICE QUESTIONS
READ CARFULLY AND CIRCLE THE LETTERS OF THE
CORRECT ANSWER
1. Of the following vacutainer tubes, which should be drawn first:

A. Yellow top for blood culture C. Gray top for glucose

B. Light-blue top for coagulation studies D. Purple top for CBC

E. Red top for electrolytes

2. Which of the following procedures is NOT part of universal precautions when

performing phlebotomy?

A. Wear a lab coat or gown C. Do not recap, break, or resheath needles

B. Change gloves between each patient. D. Use sharps containers for disposal of ALL
Needles.
E. Inform the patient of your HIV status

3. Performance of phlebotomy can create potential risks to the patient. Failure to follow
which of the following procedures creates the greatest real or potential hazard to the
patient when performing phlebotomy?

A. Wearing gloves D. Transporting specimens to the lab in less than 1 hour

B. Properly identifying the patient E. Preventing hematoma formation

C. Using the correct vacutainer tube

4. A red-stoppered vacutainer tube contains:

A. Sodium fluoride B. EDTA C. Thrombin D. No additive E. Sodium citrate

5. While performing a venipuncture on a hospital board member, the blood suddenly

stops flowing into a vacutainer tube. Which of the following is the best corrective action
to take in this situation?

A. Rotate the needle holder clockwise 1/4 turn

 B. Pull back slightly on the holder

C. Have the patient open and close his/her hand slowly

D. Push in slightly on the holder

E. Take the tube off and replace with a new tube

6. A clinical study is performed to determine the optimal time for application of the
tourniquet during phlebotomy. It is observed that if the tourniquet is left on longer than
2 minutes, changes in the value of a total protein test occur. Which of the following is
the most likely mechanism for alteration in protein values in this situation?

A. Hemolysis D. Hemostasis

B. Hemoconcentration E. Complement activation

C. Glycolysis

9. A factor that contributes to the overall professional impression made by the

Phlebotomist is:

A. Compassion C. Self-confidence

B. Dependability D. Any of the above

10. Which of the following is a duty of the phlebotomist?

A. Analyze specimens C. Obtain vital signs

B. Collect drug screens D. Transport patient

11. A patient complains of extreme pain when you insert the needle during a venipuncture
attempt. The pain does not subside, but the patient does not feel any numbness or burning
sensation. You know the needle is in the vein because the blood is flowing into the tube.
You have only two tubes to fill, and the first one is almost full. What should you do?

A. Ask the patient if he or she wants you to continue the draw.

 B. Discontinue the draw and attempt collection at another site.

C. Distract the patient with small talk and continue the draw.

D. Tell the patient to hang in there as you have only one tube left

12. Which of the following situations can result in hemoconcentration?

A. drawing a large tube with a small needle

B. leaving the tourniquet on over 1 minute

C. mixing the specimen too vigorously

D. partially filling a normal-draw tube

13. You are in the process of collecting a specimen by venipuncture. You hear a hissing
sound, there is a spurt of blood into the tube, and blood flow stops. What has most likely
happened?

A. reflux of tube contents

B. the needle went too deep

C. the vein has collapsed

D. tube vacuum escaped

14. Capillary collection is the preferred method of blood collection in infants because:

A. an infant can be injured by the restraining method used

B. removing larger quantities of blood can lead to anemia

C. venipuncture may damage veins and surrounding tissue

D. all of the above

15. When making a routine blood smear, the "pusher slide" is normally used at an angle of
how many degrees?

A. 15
B. 30
C. 45
D. 60

16. An epidemiologic study is performed with subjects who are health care workers. The
types and numbers of accidental injuries are reviewed. It is observed that needlestick
injuries occur amongst all health care workers. Which of the following groups of health
care workers is most likely to have the highest rate of needlestick injury?

A. Nurses

B. Phlebotomists

C. Physicians

D. Medical students

E. Laboratory technologists

17. When drawing a blood specimen using a light-blue top tube, a set of rules are employed.
Which of the following rules DOES NOT apply to use of a blue-top tube?

A. It should never be the first tube drawn B. It must be used only for coagulation tests

C. It must be filled completely (full draw) D. It must always be the first tube drawn

E. It must not be drawn from an IV line

18. Which of the following procedures is NOT part of universal precautions when
performing phlebotomy?

A. Wear a lab coat or gown

B. Change gloves between each patient.

C. Do not recap, break, or resheath needles

D. Use sharps containers for disposal of ALL needles

E. Inform the patient of your HIV status

19. Performance of phlebotomy can create potential risks to the patient. Failure to follow
which of the following procedures creates the greatest real or potential hazard to the
patient when performing phlebotomy?

A. Wearing gloves

B. Properly identifying the patient

C. Using the correct vacutainer tube

D. Transporting specimens to the lab in less than 1 hour

E. Preventing hematoma formation

20. A student in a hurry does not wait for the site on the skin cleaned with antiseptic to dry
before probing the phlebotomy site about 8 times with too small a needle before finally
managing to get blood by using a syringe and drawing back forcefully on the plunger.
Which of the following specimen artefacts is most likely to be caused in this situation?

A. Hemoconcentration

B. Elevation in WBC count

C. Clotting

D. Increase in creatine kinase

E. Hemolysis

21. Which of the following procedures is NOT done to obtain blood if a problem occurs
during collection?

A. Reposition the needle

B. Use an IV line

C. Try another vacutainer tube

D. Re-anchor the vein

E. Loosen the tourniquet

22. A red-stoppered vacutainer tube contains:

A. Sodium fluoride

B. EDTA

C. Thrombin

D. No additive

E. Sodium citrate

23. While performing a venipuncture on a hospital board member, the blood suddenly
stops flowing into a vacutainer tube. Which of the following is the best corrective action to
take in this situation?

A. Rotate the needle holder clockwise 1/4 turn

B. Pull back slightly on the holder

C. Have the patient open and close his/her hand slowly

D. Push in slightly on the holder

E. Take the tube off and replace with a new tube

24. The proper way to insert a needle is with the bevel facing ____________.

A. Right

B. Left

C. Up

D. Down
25. When performing a routine skin puncture, the site should be alcohol cleaned and _____

A. Rinsed with soap and water

B. Followed by iodine cleaning

C. Allowed to air dry on its own

D. Blown dry to expedite things

26. How long should a tourniquet stay on the patient/client arm?

A. 1 hour

B. 30 minutes

C. 2 minutes

D. 3 hours

27. Can a phlebotomist legally draw blood from a fully cognizant (awake and aware)
patient who refuses consent to it?

A. Yes with physician consent

B. Yes with administrative consent

C. No

D. Yes with nurse consent

28. What tube is used for ESR?

A. Yellow

B. Lavender

C. Green

D. Red
29. Squeezing the finger too vigorously during the capillary blood collection can cause
erroneous lab results due to:

A. Skin contamination

B. Blood cell concentration

C. Dilution with tissue fluid

D. Clotting at the puncture site

30. A complete blood count (CBC) is collected in an evacuated tube with what color
stopper?

A. Red

B. Black

C. RAINBOWZ

D. Lavender

E. Blue

31. Which of the following is the best definition of destruction of red blood cells?

A. Hemoglobin C. Hemolysis

B. Homeostasis D. Hemostasis

32. When entering a room marked with isolation signs, __________.

A. Ask a nurse if gown, mask or gloves are needed

B. Read isolation signs to determine what PPE is appropriate

C. Go on it, as short visits in isolation do not matter

D. Ask the patient what the nurses wear

33. Sodium Citrate has what color stoppers?

A. Green

B. Lavender

C. Light blue

D. Red

35. Red and white blood cell counts are examples of __________ tests.

A. Hematology

B. Chemistry

C. Microbiology

D. Blood banking

36. The process by which an object or area becomes unclean is known as __________.

A. Colonization B. Sterilization

B. Infection C. Contamination

37. A group of tests collected as one unit:

A. STAT

B. Bunch

C. Profile

D. Group
38. After drawing blood from a patient, the phlebotomist should dispose of the needle
by __________.

A. Recapping it carefully and bringing it back to the lab

B. Depositing it in an approved "sharps container"

C. Tossing it into waste cans in the laboratory

D. Breaking it so it cannot be reused by anyone

39. What information must be included if the phlebotomist must manually label a blood
collection tube from an outpatient?

A. Date of patients birth and/or social security number

B. Date and time of draw

C. Patients full name and phlebotomist initials

D. All of the above

40. Which additive is usually in a lavender tube?

A. Heparin B. Citrate

C. Oxalate D. EDTA

41. What is the first link in the chain of infection?

A. Susceptible host

B. Portal of exit

C. Agent
42. The body system the filters blood to eliminate waste, helps maintain blood PH and
regulates water balance is the _______ system.

A. Cardiovasular

B. Nervous

C. Urinary

D. Respiratory

43. Which of the following causes AIDS?

A. HBV

B. RSV

C. CMV

D. HIV

44. Infections that can be spread from person to person are called __________.

A. Environmental

B. Communicable

C. Indirect

D. Vector-borne

45. How many times should a red top tube be inverted?

A. 0 B. 8 C. 2 D. 5

46. Chemicals that prevent blood from clotting are called __________.
A. Preservatives B. Adhesives C. Activators D. Anticoagulants

47. All patients are presumed to be infectious for ___________.

A. Blood borne pathogens

B. TB

C. Common cold

D. Flu

48. Before performing a venipuncture, why will a phlebotomist tie a tourniquet?

A. To dull the pain at the puncture site

B. To insure thrombosis occurs

C. To elevate the blood pressure

D. To help locate the veins in the antecubital

49. The following were collected for a routine venipuncture. Which item is incorrect?

A. Touniquet B. Iodine swab C. Tubes D. Safety needles

50. The smallest veins of the human anatomy are known as_____

A. Arterioles

B. Capillaries

C. Venules

D. Arteries
51. The single, most important way to prevent the spread of infection while performing
phlebotomy is by __________.

A. Wearing a mask

B. Washing hands

C. Burning waste

D. Cleaning spills

52. Paul phlebotomist draws CBC on patient Fred Jones, labels the lavender top tube
and remove his gloves to go to lunch. Before he can leave patient Sam smith is sent to
phlebotomist to have a full lipid profile drawn. Paul puts on new gloves and draws a red
top tube he records the # hours post prandial. What step is missing?

A. Hands aren’t washed in between

B. Red top tube is incorrect

C. Lavender tube is incorrect

D. Hours postprandial aren’t needed

53. Which is not true off WBCs?

A. They are also called leukocytes

B. They are formed in bone marrow and lymph tissues

C. They are a defense mechanism

D. They are all the same size and shape

55. Which is not a PPE?

A. Mask C. Room dividers

B. Goggles D. Gloves
56. Which of the following is the single most common source of HIV and HBV in the
workplace?

A. Pleural fluid

B. Saliva

C. Blood

D. Semen

57. Which tube can be used to collect blood for a type and crossmatch?

A. Pink top EDTA

B. Serum seperator tube

C. Royal Blue top

D. Gray top

58. Which tube is sometimes called a serum separator tube?

A. Red/gray

B. Red

C. Light blue

D. Green

59. Negligence by a professional person is called __________.

A. Invasion of privacy

B. Tort

C. Malpractice

D. Slander
61. If a glass tube breaks during centrifugation, what sequence of actions would be
best?

A. Leave the room and dance around

B. Stop the centrifuge open the lid and use forceps to remove any glass

C. Open the lid stop the centrifuge and remove the glass wearing gloves

D. Evacuate the room open the lid and remove the glass with forceps

63. Treating ALL lab specimens as if they are hazardous and infectious is the basis for

A. Universal precautions

B. Quality assurance programs

C. Hazardous waste controls

D. Patient quarantine systems

64. Blood types are determined by the presence or absence of which of the following on
RBCs.

A. Antibodies

B. Antigens

C. Chemicals

D. Hormones

65. Which should not be done during vein selection?

A. Lowering the patient's arm C. Placing a warm towel on the arm.

B. Palpating the antecubital D. Patient pumping fist

66. The study of blood is called __________.

A. Hemolysis C. Hemoglobin

B. Hematology D. Hematoxins

67. Failing to provide reasonable standards of care causing someone to suffer an injury
is known as ____________.

A. Battery B. Tort

C. Trauma D. Negligence

68. Which is used for PT and PTT?

A. Light blue top C. Red top

B. Green top D. Gray top

69. When using evacuated tubes for blood collection, it is crucial to remember to
__________.

A. Immediately invert any tubes that contain additives

B. Never to under fill tubes that contain anticoagulant

C. Never to use tubes past their stated expiration date

D. All of the above

70. Which is not an infection control method?

A. Sphygmomanometers

B. Protective clothing

C. Hand washing
D. Biohazard containers

71. A violation of a person's right to have his or her name, photograph, or private
affairs made public without giving consent is called __________.

A. Invasion of privacy B. Malpractice C. Assault D. Battery

72. If the information of the patients id breacelet is NOT identical to the information on
the phlebotomy test requisition and labels for that patient, the phlebotomist should
_____

A. Refrain from drawing the sample until ID is resolved

B. Ignore the id bracelet and proceed

C. Change the ID band information to match the requisition

D. Telephone the physician for help in identifying the patient

73. The color of normal serum is usually __________.

A. Hazy brown B. Clear red C. Straw to yellow D. Milky white

75. Which blood vessel is NOT part of systemic circulation?

A. Brachial artery B. Cephalic vein C. Pulmonary artery D. Vena cava

76. The heart, lymphatic organs, and blood vessels are in the __________.

A. Cardiovascular system B. Urinary system

C. Digestive system D. Respiratory system

77. The venipuncture site should be cleansed in a circular motion from the center to the
__________.

A. Opposite side you started from B. Periphery

C. Injection point D. None of the above

78. The hands of the phlebotomist should be washed _________

A. Before inspection collection

B. After specimen collection

C. Even though gloves are used

D. All answers are correct

79. When the body has adequate rest and no food for 12 hours it is said to be in
the___________state.

A. Steady B. Hemostasis C. Basal D. Homestasis

80. If a patient refuses blood collection you should?

A. Tell your supervisor

B. Call 911

C. Tell them it is their life

D. Restrain him