30 questions weighted like the NHA Certified Phlebotomy Technician (CPT) exam, built on NHA's current test plan from its 2024 job analysis. Instant answers, plain explanations, and a score by domain at the end.
30
Questions
5
Domains, real weights
100%
Answers sourced
0
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How this test is weighted
Safety and Compliance
26% of the NHA CPT
8 questions here
Patient Preparation
20% of the NHA CPT
6 questions here
Routine Blood Collections
28% of the NHA CPT
8 questions here
Special Collections
12% of the NHA CPT
4 questions here
Processing
14% of the NHA CPT
4 questions here
Click an answer to check it. Each question shows why the answer is right and the public source it comes from (NHA test plan, OSHA, CDC, hospital lab collection manuals).
Q1 · Safety and Compliance
You have just finished a routine venipuncture with an evacuated tube holder and a safety needle. What should you do with the needle?
The answer is B. OSHA's bloodborne pathogens standard says contaminated needles must not be bent, recapped or removed unless no alternative is feasible, and sharps go into a closable, puncture-resistant, leakproof, labeled container. BD's guidance is to use the built-in needle protector and discard the device in an approved sharps container.
While discarding a used needle, a phlebotomist is stuck in the finger. What should she do first?
The answer is D. CDC/NIOSH first steps after a needlestick: wash needlesticks and cuts with soap and water, report the incident to your supervisor, and seek medical treatment immediately. Under OSHA, the employer must then make a confidential medical evaluation and follow-up available.
A patient with suspected pulmonary tuberculosis is on airborne precautions. What respiratory protection does the phlebotomist need to enter the room for a blood draw?
The answer is A. CDC lists pulmonary tuberculosis under airborne precautions, and airborne precautions call for a fit-tested NIOSH-approved N95 or higher-level respirator for healthcare personnel. A surgical mask or face shield does not filter airborne particles the way a fitted respirator does.
A phlebotomist wearing gloves, a gown, goggles and an N95 respirator finishes a draw in an airborne isolation room. Following CDC's PPE removal guidance, which item does she take off only after leaving the room and closing the door?
The answer is C. CDC: remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Gloves, goggles and gown come off inside the room.
After removing her gloves, a phlebotomist sees blood on the back of her hand. How should she clean her hands?
The answer is B. CDC says healthcare personnel should wash with soap and water when hands are visibly soiled. Alcohol-based hand rub is for hands that are not visibly soiled, and gloves never replace hand hygiene.
Before testing patients, a phlebotomist runs the controls on a CLIA-waived glucose meter, and one control result falls outside its acceptable range. What should she do?
The answer is A. CDC's waived-testing guidance: if controls do not give the expected results, wait until the problem is identified and corrected before reporting patient results. Troubleshoot using the manufacturer's instructions, repeat QC, and only when it is acceptable re-test patient samples and report.
A phlebotomist checking the specimen refrigerator's temperature log on Monday sees that nobody read the thermometer on Saturday, and there is no recorded data for that day. What should be entered for Saturday?
The answer is D. CDC's instructions for temperature logs: if a reading is missed and there is no temperature data for that time, the entry should remain blank. Do not make up or guess what the temperature was.
Halfway through a venipuncture, a seated patient's eyes roll back and he slumps in the chair. What should the phlebotomist do first?
The answer is C. If a patient faints during collection, immediately abort the procedure: remove the tourniquet and needle, apply gauze and pressure to the puncture site, and call for assistance. Stay with the patient until fully recovered. Never leave a needle in a fainting patient or try to walk him.
An inpatient's requisition is for a morning CBC. Which pair of identifiers is acceptable for confirming you have the right patient?
The answer is A. The Joint Commission requires at least two person-specific identifiers when collecting specimens, and the patient's room number or physical location is not used as an identifier. Name plus date of birth (ideally stated by the patient) is a standard acceptable pair.
An outpatient on dialysis has an arteriovenous fistula in her left arm. The veins in her right antecubital area are easy to feel. Where should you draw?
The answer is B. Hospital collection procedures direct phlebotomists not to use the side of a fistula (or a mastectomy) and to avoid IV sites, burns, scars and hematomas. With good veins in the other arm, draw from the right arm.
Before an outpatient draw, a patient tells you he fainted the last two times he had blood taken. What is the safest way to proceed?
The answer is C. If a patient usually feels light-headed or has fainted during blood collection before, have the patient lie down for the draw if possible. Lying down removes the risk of falling from a chair if he faints again.
You are giving a patient instructions for a clean-catch (midstream) urine sample. Which instruction is correct?
The answer is D. MedlinePlus clean-catch instructions: clean the genital area with the wipe, urinate a small amount into the toilet bowl, stop, then collect urine into the clean or sterile cup until it is about half full. The first part of the stream flushes away germs from the urethra.
A patient scheduled for a fasting blood glucose test the next morning asks what she may have before the draw. What is correct?
The answer is B. For a fasting blood glucose test the patient must fast, not eating or drinking anything except water, for at least 8 hours beforehand.
A requisition orders a PT/INR for a patient taking warfarin. Which tube do you collect?
The answer is A. PT/INR is a coagulation test collected in the light blue sodium citrate tube. Lavender EDTA is used for hematology such as a CBC, gray fluoride for glucose and lactate, and gold SST for most chemistry on serum.
You will use a winged (butterfly) collection set, and the only tube ordered is a light blue sodium citrate tube for coagulation testing. What should you do?
The answer is C. When a winged set is used and a citrate tube is the first tube, BD and CLSI-based guides call for a discard tube first. It fills the tubing's dead space with blood so the citrate tube gets the right blood-to-additive ratio. The discard tube should be a non-additive or coagulation tube, never EDTA, and does not have to be filled completely.
Per standard venipuncture procedure, what is the longest a tourniquet should stay on the patient's arm?
The answer is D. Hospital procedures based on CLSI standards say not to leave the tourniquet on longer than one minute. If it has been on longer, release it, wait two minutes and reapply.
You have cleaned the antecubital site with a 70% isopropyl alcohol pad. What should you do next?
The answer is A. Allow the alcohol to air dry for at least 30 seconds before the puncture (or dry with sterile gauze if needed) so no residual alcohol remains, and do not touch the site once it has been cleaned.
A patient's orders need a light blue (citrate), lavender (EDTA), gray (fluoride) and gold (SST) tube, all drawn with one venipuncture. Which sequence follows the standard order of draw?
The answer is B. BD's order of draw, which reflects CLSI: blood cultures, citrate (light blue), serum tubes including SST (gold or red), heparin (green), EDTA (lavender), then fluoride (gray). So: light blue, gold, lavender, gray.
During a draw, a swelling quickly appears under the skin around the needle. What should the phlebotomist do?
The answer is C. A hematoma forming means blood is leaking into the tissue. Stop the draw: release the tourniquet, remove the needle immediately, apply pressure for at least 2 minutes, and use a cold compress. The tourniquet should come off before the needle is withdrawn.
How many times should a BD Vacutainer light blue sodium citrate tube be gently inverted right after it is filled?
The answer is D. BD's mixing guide: citrate tubes 3 to 4 inversions; SST 5; plastic serum tubes 5; heparin, EDTA and fluoride tubes 8 to 10. Each inversion is a gentle 180-degree turn and back.
A fingerstick is ordered for a CBC (lavender EDTA microtainer), a lithium heparin (green) chemistry microtainer, and a serum (gold) microtainer. Which microtainer should be filled first?
The answer is B. Capillary order of draw differs from venous. EDTA (lavender) microtainers are collected first, then lithium heparin, then the other additive tubes, with serum tubes (gold SST, red) last.
When should the tubes from a venipuncture be labeled?
The answer is A. The Joint Commission requires specimen containers to be labeled in the presence of the patient. Hospital procedures say to label all specimens at the draw station in the presence of the patient and have the patient or guardian verify the labels.
You are collecting one set of blood cultures (an aerobic and an anaerobic bottle) using a butterfly needle. Which bottle do you fill first, and why?
The answer is C. With a butterfly set, the air in the tubing is drawn into the first culture bottle. Since that air could affect the anaerobic culture, the aerobic bottle is drawn first and the anaerobic bottle second. Both adult bottles take the same 8 to 10 mL.
You are collecting a newborn's heelstick blood onto a filter-paper card for screening tests such as PKU. Which technique is correct?
The answer is D. For filter-paper collection, touch the paper only to the blood (not the skin), apply one large drop per circle on the printed side, never add blood to a circle that is already partly filled, and make sure the blood saturates the circle and shows through on both sides. Avoid squeezing hard, which pushes tissue fluid into the drop.
A facility limits blood drawn from infants to 3% of estimated total blood volume in 24 hours, and estimates blood volume at 80 mL/kg. How much blood, at most, may be drawn in 24 hours from an infant who weighs 6 kg?
The answer is A. Total blood volume = 6 kg x 80 mL/kg = 480 mL. 3% of 480 mL = 14.4 mL. Published pediatric guidelines set limits from 1% to 5% of total blood volume in 24 hours (up to 10% over 8 weeks), so each facility's own policy number is the one to use.
A phlebotomist is collecting a blood alcohol specimen for a legal case. Which skin antiseptic should she use?
The answer is B. Alcohol must be kept out of a blood alcohol specimen. State rules for legal blood alcohol draws (Hawaii's, for example) require cleansing with a non-alcoholic aqueous antiseptic such as benzalkonium chloride or povidone-iodine. Note that the chlorhexidine choice here also contains 70% isopropyl alcohol.
You are aliquoting serum from a newborn's bilirubin specimen for transport to the testing lab. Which container should you use?
The answer is D. Bilirubin is light-sensitive. Lab test directories direct that bilirubin samples be aliquoted into an amber (light-protecting) vial for transport and protected from light; specimens over 4 hours old that were not protected from light are rejected.
A plasma ammonia level is collected in the morning. How should the specimen be handled after collection?
The answer is C. Hospital guides list ammonia as "transport on ice" and require inpatient samples on ice in the lab within about 20 minutes; they also say not to freeze it.
For a federally regulated (DOT) workplace drug test, what does the chain of custody do?
The answer is A. Federal DOT rules define chain of custody as the procedure used to document the handling of the specimen from the time the employee gives it to the collector until it is destroyed, using the Federal Drug Testing Custody and Control Form (CCF).
A point-of-care blood glucose result on an outpatient falls in the facility's critical-value range. What should the phlebotomist do?
The answer is B. Critical values are results that need immediate evaluation or treatment by the physician. CDC's waived-testing guidance says staff must know how to alert the physician promptly and document when and to whom critical values are reported.
120 multiple-choice questions, 100 scored and 20 unscored pretest items, in 2 hours. You need a scaled score of 390 (on a 200 to 500 scale) to pass.
Taken at your school, a PSI testing center, or by live remote proctoring. NHA lists the exam fee in its online shop. If you fail, you can retest after 30 days, up to three attempts, and each retake costs the full fee again.
Current test plan from NHA's 2024 job analysis: five domains, led by Routine Blood Collections (28%) and Safety and Compliance (26%). To sit the exam you also need 30 venipunctures and 10 capillary sticks on live people. ASCP (PBT) and AMT (RPT) offer other phlebotomy certifications with similar content.
From NHA's official NHA CPT test plan. CertOutlook is not affiliated with NHA. Practice questions are original and are not taken from the exam.