NHA Phlebotomy
NHA Phlebotomy is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
NHA Phlebotomy is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
10 sample questions for the NHA Phlebotomy, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.
Sections covered on the exam: Legalandprofessionalconsiderations, Laboratorystandardsandregulations, Qualitycontrolandqualityassurance, Infectioncontrol, Laboratoryhazardsandemergencyresponse, Safety and Compliance, Patient Preparation, Laboratoryordersanddocumentation, Testrequirementsandspecialconsiderations, Medicalterminology, Suppliesandequipment, Tubes,Additives,Andorderofdraw, Venipunctureprocedure, Routine Blood Collections, Special Collections, Timedandforensiccollections, Specialpopulationsanddonorcollections, Point-Of-Caretesting, Non-Bloodspecimens, Specimenhandlingandtransport, Processing, Specimenintegrityandresultreporting.
Question 1 · Legalandprofessionalconsiderations
An outpatient is hesitant about a venipuncture. Frustrated, the phlebotomist says, "If you don't hold your arm still, I'll have security come in and hold you down." The patient becomes frightened, but no one touches the patient. Which legal wrong has the phlebotomist MOST likely committed?
Answer: B. Assault
Assault is a threat or attempt to cause harmful contact that makes a person fear being touched, even if no contact occurs. Battery requires actual unauthorized touching, which did not happen here. False imprisonment would require actually confining the patient, and nothing about the patient's private information was disclosed.
Question 2 · Laboratoryhazardsandemergencyresponse
While preparing a bleach disinfectant solution, a phlebotomist splashes some into one eye. Which response is correct?
Answer: A. Flush the eye at the eyewash station for at least 15 minutes
Chemical splashes to the eye require immediate, continuous flushing at an eyewash station for at least 15 minutes while holding the eyelids open, followed by medical evaluation. A 2- or 5-minute rinse is too short to remove the chemical adequately. Covering the eye before flushing leaves the chemical in contact with the eye.
Question 3 · Testrequirementsandspecialconsiderations
A patient had a left mastectomy with lymph node removal. An IV is infusing in the right antecubital area. No physician order addresses the left arm. Which site is MOST appropriate?
Answer: D. Right hand vein below the IV, after the nurse stops the infusion for 2 minutes
When the only available arm has an IV, the specimen is collected below the IV after the nurse stops the infusion for about 2 minutes, with the first 5 mL discarded and the circumstance documented. The left hand vein is the tempting error; the restriction applies to the entire arm on the side of lymph node removal, not just the area near the surgery.
Question 4 · Venipunctureprocedure
The first tube fills normally, but when a phlebotomist pushes the second tube onto the holder, no blood enters it. The needle has not moved and the patient reports no discomfort. What should the phlebotomist do FIRST?
Answer: C. Remove the tube and try a new tube, since the first may have lost its vacuum
When a correctly positioned needle has already produced flow, the most likely cause of a tube that will not fill is loss of vacuum, so trying a new tube is the first step. Repositioning the needle is a reasonable next step only if a fresh tube also fails. A second puncture is premature, and tightening the tourniquet adds venous stasis without addressing the cause.
Question 5 · Specialpopulationsanddonorcollections
A neonatal unit limits blood removal to 3% of total blood volume in 24 hours and estimates newborn blood volume at 80 mL/kg. What is the MAXIMUM volume that may be drawn in 24 hours from an infant who weighs 4.2 kg?
Answer: D. 10.1 mL
Total blood volume is 4.2 kg × 80 mL/kg = 336 mL, and 3% of 336 mL is about 10.1 mL. Taking 3% of 80 mL/kg per kilogram and forgetting to multiply by weight gives 2.4 mL, using 100 mL/kg instead of the unit's 80 mL/kg gives 12.6 mL, and 33.6 mL is 10% of the blood volume rather than 3%.
Question 6 · Legalandprofessionalconsiderations
The needle is in the vein and the first tube is filling when the patient says, "Stop, I don't want this anymore." Which action should the phlebotomist take?
Answer: B. Release the tourniquet, remove the needle, and apply pressure
A patient may withdraw consent at any time, even during a procedure, so the phlebotomist must stop, remove the tourniquet and needle, apply pressure, and then notify the nurse or provider and document. Continuing after consent is withdrawn, even to finish one tube, constitutes battery. Consent given at the start does not bind the patient for the rest of the procedure.
Question 7 · Laboratoryhazardsandemergencyresponse
A phlebotomist sees an NFPA 704 diamond on a cabinet storing a reagent. The blue section shows 3, the red section shows 0, and the yellow section shows 1. What does this label indicate?
Answer: D. Serious health hazard, not flammable, slightly unstable
On the NFPA diamond, blue is health, red is flammability, yellow is instability or reactivity, and white shows special hazards, rated from 0 (minimal) to 4 (severe). A blue 3 means a serious health hazard, red 0 means it will not burn, and yellow 1 means slight instability. Confusing the colors, for example reading red as health, leads to the other interpretations.
Question 8 · Testrequirementsandspecialconsiderations
An obese patient needs a routine venipuncture, and no antecubital veins are visible when the standard tourniquet is applied. Which approach is MOST appropriate?
Answer: D. Use a longer tourniquet or a cuff at about 40 mm Hg and palpate for the cephalic vein
In obese patients a longer tourniquet or blood pressure cuff inflated to no more than about 40 mm Hg can be used, and the cephalic vein is often the easiest to palpate. Leaving a tourniquet on longer than 1 minute causes hemoconcentration. The basilic vein is the last antecubital choice because of nearby nerves and the brachial artery, and ankle veins require physician permission.
Question 9 · Venipunctureprocedure
Where and how tightly should a tourniquet be applied for an antecubital venipuncture?
Answer: B. 3 to 4 inches above the site, tight enough to slow venous but not arterial flow
The tourniquet is placed 3 to 4 inches above the site and should obstruct venous return while allowing arterial blood to keep flowing into the arm. Stopping arterial flow, as indicated by a lost radial pulse, prevents the veins from filling and harms the patient. A tourniquet placed too close interferes with the puncture, and one that is too loose fails to distend the veins.
Question 10 · Specialpopulationsanddonorcollections
A phlebotomist is collecting a newborn screening specimen on a filter paper card from a 36-hour-old infant. Which technique is correct?
Answer: C. Apply one large drop to each circle from one side only until blood soaks through to the back
Each circle is filled from one side with a single large drop that saturates through the paper, which gives the uniform thickness needed for accurate results. Layering multiple drops or applying blood from both sides produces uneven, over-saturated spots, and the card is then air dried horizontally away from heat and sunlight.
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