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PHLEBOTOMY ALL VERSION 2 QUESTIONS AND
VERIFIED CORRECT ANSWERS (ACCURATE
SOLUTIONS) ALREADY PASSED HIGHEST TEST
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- Which vein is most commonly used for venipuncture? a) Brachial vein b) Femoral vein c) Median cubital vein d) Basilic vein The median cubital vein is large, superficial, and has good support, making it the vein of choice.
- Which additive is found in a lavender-top tube? a) Heparin b) EDTA c) Sodium citrate d) Potassium oxalate EDTA prevents clotting by binding calcium; it’s used for CBC and hematology tests.
- What is the proper angle for needle insertion during venipuncture? a) 15-30 degrees b) 15 - 30 degrees
c) 45 degrees d) 60 degrees A 15-30 degree angle helps access the vein without going through it.
- Which order of draw is correct? a) Red, Light Blue, Lavender, Green b) Light Blue, Red, Green, Lavender c) Blood cultures, Light Blue, Red, Green, Lavender, Gray d) Lavender, Green, Red, Gray This order minimizes cross-contamination of additives.
- What is the first step if a patient faints during venipuncture? a) Call a code b) Remove the needle immediately c) Get ammonia inhalant d) Continue drawing Removing the needle prevents injury to the patient during syncope.
- Which specimen requires special handling and must be protected from light? a) Potassium b) Bilirubin c) Bilirubin d) Sodium Bilirubin breaks down in light; use amber tubes or wrap in foil.
- When is a blood culture typically ordered? a) For diabetes
b) Lavender c) Light blue d) Green Light blue tubes contain sodium citrate; underfilling alters the blood-to- additive ratio. 12.What can cause a hematoma during venipuncture? a) Using a butterfly needle b) Failure to apply pressure c) Using the median cubital vein d) Anchoring the vein Not applying pressure allows blood to leak into surrounding tissue. 13.What is the most common cause of contamination in blood cultures? a) Improper skin antisepsis b) Wrong tube used c) Using a butterfly needle d) Overfilling tube Improper antisepsis allows skin bacteria into the culture. 14.How long should the tourniquet be applied? a) 30 seconds b) 1 minute c) 2 minutes d) 3 minutes More than 1 minute can cause hemoconcentration and inaccurate results.
15.Why is it important to invert tubes with additives? a) To prevent hemolysis b) To mix blood cells c) To mix additive and blood d) To reduce contamination Proper mixing prevents clot formation. 16.Which tube is used for glucose testing? a) Red b) Light blue c) Gray d) Green Gray-top tubes contain sodium fluoride to prevent glycolysis. 17.What is the best site for capillary puncture in adults? a) Earlobe b) Heel c) Finger (middle or ring) d) Thumb The middle or ring finger has fewer calluses and nerves. 18.How should you identify an unconscious patient? a) Family says the name b) Check ID band c) Guess from chart d) Ask a nurse later Always verify identity with ID band.
d) Ulnar artery The radial artery is accessible and has good collateral circulation. 23.Which specimen must be chilled after collection? a) Bilirubin b) Potassium c) Ammonia d) Glucose Ammonia is unstable at room temperature. 24.How long should pressure be applied after arterial puncture? a) 1 minute b) 5 - 10 minutes c) 30 seconds d) Until it clots Arterial punctures bleed more than venous. 25.Which color tube has no additive? a) Lavender b) Red c) Gray d) Green Plain red-top tubes allow blood to clot for serum collection. 26.What does a sclerosed vein feel like? a) Spongy b) Soft c) Hard and cord-like
d) Pulsating Sclerosed veins are damaged and unsuitable for draws. 27.Which condition requires airborne precautions? a) MRSA b) Tuberculosis c) C. diff d) HIV TB spreads through airborne particles. 28.What is the minimum PPE for blood draw? a) Gown only b) Gloves c) Face shield d) N95 mask Gloves protect both patient and phlebotomist. 29.Which of the following is true about fasting specimens? a) Fasting is unnecessary b) Patient must not eat for 8-12 hours c) Only drink juice d) No effect on glucose Eating affects glucose and lipid levels. 30.What is an accession number? a) Tube size b) Test name c) Unique ID for specimen
d) Green Light blue tubes contain sodium citrate for PT/PTT tests. 35.Which specimen requires anaerobic collection? a) WBC b) Blood culture c) Glucose d) Platelet count Blood cultures need anaerobic and aerobic bottles to detect bacteria. 36.Which is true about OSHA? a) They provide PPE b) They enforce safety standards c) They collect specimens d) They test samples OSHA sets standards for workplace safety. 37.What is implied consent? a) Written form b) Verbal statement c) Patient’s actions indicate agreement d) Nurse’s permission Holding out an arm indicates implied consent. 38.Which vein is near the brachial artery and should be used cautiously? a) Median cubital b) Cephalic c) Basilic
d) Femoral The basilic vein is close to major arteries and nerves. 39.What does hemoconcentration mean? a) Low blood count b) Increased cell concentration c) Clotting faster d) Vein collapse Tourniquet left too long can concentrate cells. 40.Which is an acceptable capillary puncture site for an infant? a) Earlobe b) Finger c) Heel d) Thumb The heel is safest for infants under 1 year. 41.What is the additive in green-top tubes? a) Citrate b) Heparin c) EDTA d) Fluoride Heparin prevents clotting by inhibiting thrombin. 42.What is the CLSI? a) Certifies labs b) Sets laboratory standards c) Makes syringes
d) Gray Blood cultures must be sterile, so draw them first. 47.What is basal state? a) After exercise b) After lunch c) Early morning, fasting d) After transfusion Basal state provides the most accurate lab values. 48.Which test is used for diabetes monitoring? a) BUN b) Hemoglobin c) Hemoglobin A1C d) Bilirubin HbA1C measures average blood glucose over 2-3 months. 49.What is the risk of drawing from the foot vein? a) Hemoconcentration b) Thrombosis c) Phlebitis d) Nerve damage Foot veins have higher risk of clot formation. 50.Which position helps prevent fainting? a) Standing b) Sitting or lying down c) Head tilted back
d) Arms raised Patients should sit or lie down to reduce fall risk. 51.Which situation would require contact precautions? a) Tuberculosis b) Influenza c) Clostridium difficile (C. diff) d) HIV C. diff spreads through contact with contaminated surfaces; gloves and gowns are needed. 52.What should you do if a patient refuses a draw? a) Call security b) Force the draw c) Document refusal and notify nurse d) Ignore it Patient refusal must be respected; document and inform the healthcare team. 53.Which complication is least likely during a fingerstick? a) Bruising b) Infection c) Hemolysis d) Syncope (fainting) Fainting is rare during a small fingerstick.
58.Which is not part of standard precautions? a) Hand hygiene b) Use of gloves c) Safe needle disposal d) Using a respirator for all patients Respirators are for airborne precautions, not standard precautions. 59.Which tube is used for a sedimentation rate? a) Red b) Light blue c) Green d) Lavender Sedimentation rate requires whole blood anticoagulated with EDTA. 60.Which test is time-sensitive and must be drawn at a specific time? a) Hemoglobin b) Peak/trough drug levels c) Potassium d) ESR Therapeutic drug monitoring depends on precise timing. 61.What is the purpose of a tourniquet? a) Sterilize the site b) Anchor the vein c) Engorge veins with blood d) Stop bleeding A tourniquet slows venous return to make veins easier to find.
62.Which condition might require drawing from a hand vein? a) Hemophilia b) No accessible veins in antecubital area c) Hypoglycemia d) Fainting Hand veins are used when arm veins are inaccessible. 63.Why must you never draw above an IV site? a) The vein is too small b) It hurts c) IV fluid dilutes the specimen d) The vein will collapse IV fluids contaminate the sample. 64.How do you prevent hemolysis? a) Shake tubes b) Draw with a small needle c) Use the correct needle size and gentle mixing d) Use a large syringe Proper needle size and gentle handling reduce red cell damage. 65.Which situation increases risk of needlestick? a) Using a safety needle b) Disposing in a sharps container c) Recapping a used needle d) Wearing gloves Recapping is the leading cause of accidental sticks.
70.What should be done for a fasting glucose draw if the patient ate breakfast? a) Continue anyway b) Consult the nurse or doctor c) Draw and mark “fasting” d) Refuse the draw Report the issue before proceeding; results would be inaccurate. 71.What is the main risk of drawing from the underside of the wrist? a) Hemolysis b) Bruising c) Nerve damage d) Hemoconcentration Nerves run close to veins under the wrist. 72.What does POCT stand for? a) Patient outcome check time b) Point-of-care testing c) Proper order collection test d) Phlebotomy order count time POCT means testing done at or near the patient’s side. 73.What is the most important step in preventing infection? a) Wearing gloves b) Hand hygiene c) Changing needles
d) Using alcohol wipes Handwashing is the #1 infection control method. 74.Which tube is used for blood bank testing? a) Green b) Pink c) Gray d) Light blue Pink-top tubes contain EDTA and are used for crossmatching. 75.How do you handle a patient who is combative? a) Hold them down b) Ask for assistance c) Proceed alone quickly d) Call police immediately Get help to ensure safety for all involved. 76.What does a blood smear check for? a) Glucose b) Cell morphology c) Coagulation time d) Drug levels Smears help diagnose anemia and blood disorders. 77.Which is the best site for a heel stick? a) Center of heel b) Lateral or medial plantar surface c) Big toe
