National Center for Competency Testing (NCCT) Practice Exam

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• Which action by the phlebotomist is the FIRST line of defense in preventing the spread of microorganisms?
• Why is a bandage not used after drawing blood from a newborn with hyperbilirubinemia?
• A patient brings in a mix of POC and higher complexity tests and asks for interpretation. What should the phlebotomist do?
• Which item is NOT listed as PPE in the described isolation precautions scenario with gown, gloves, and mask?
• Which situation requires corrective action before test results can be given to the doctor?
• In drawing multiple tests such as blood culture, sedimentation rate, PTT, and glucose, which is the correct order of draw?
• Some plastic tubes prevent platelet adhesion, leading to delayed clotting because
• A phlebotomist arrives at an inpatient room with an isolation cart outside and PPE of gown, gloves, and mask. Which precautions are being used?
• Which PPE is the minimum required when drawing blood from a patient with suspected HIV, as described in the material?
• Which personal wellness area conveys the strongest impression of optimal health?
• Rh factor refers to a surface antigen located on which cells?
• What is the correct order of PPE removal before leaving the exam room for a patient in contact-droplet isolation?
• Which is the CLSI recommended capillary collection order?
• To minimize hematoma formation, which practice is correct during venipuncture?
• A phlebotomist has a requisition to draw blood from a patient with a coagulation disorder. The phlebotomist should be sure to
• Which scenario best represents a hospital-acquired infection?
• Endocarditis is an infection of which part of the heart?
• After introducing herself and identifying the patient, what should the phlebotomist do next?
• Which method appropriately verifies a patient’s identity prior to phlebotomy?
• The heat from a warm compress will encourage capillary vasodilation resulting in increased blood flow. Warm the heel for 3-5 minutes, which allows sufficient time for the capillaries to dilate. What is the purpose of warming the heel before capillary puncture?
• The phlebotomist is instructed to perform a capillary stick for newborn screening. Which collection device should be used?
• In a patient requiring a complete blood count with differential, partial thromboplastin time, basic metabolic panel, and blood cultures, what is the correct order of draw?
• For a urine sample, which timing is ideal for many tests?
• Which action is outside the scope of practice for a phlebotomist?
• Which color top is typically used for CBC collection in standard practice described?
• Which statement best describes capillary blood collection in pediatric patients?
• A phlebotomist is using an evacuated tube holder and multi-sample needle to collect a CBC, PT, and BUN. The correct order of draw for this collection is
• Where should a phlebotomist dispose of gloves after a venipuncture if there is blood on them?
• Which venipuncture site should be avoided in a patient who has had a left mastectomy?
• The 24-hour urine collection must begin and end with empty conditions. Which statement best describes the timing?
• A patient with very small, difficult veins requires three tubes. The lavender tube fills incompletely despite proper technique. What should be done NEXT?
• In a blood culture collection using a winged infusion set on an adult, which tube must be drawn first?
• Immunization currently available for prevention of which bloodborne disease?
• Which of the following is a requirement for OSHA compliance in a healthcare facility?
• If the phlebotomist does not see a blood return after inserting the needle for CBC and PTT, what should be done next?
• A non-responsive patient in an emergency department would be drawn under which type of consent?
• When disposing of hazardous materials, the phlebotomist must adhere to the guidelines and standards set forth by
• Which of the following is a normal blood pressure reading?
• Protective isolation is typically used for patients with which condition among the following?
• What is the CLSI recommended micro-collection order of draw for a BMP, CBC and bilirubin?
• The phlebotomist applies the tourniquet, but then has trouble relocating the vein after several minutes of palpation. Which of the following is an expected outcome in these test results?
• Which vein is commonly used for venipuncture in the antecubital fossa and is often preferred for routine blood draws?
• Which of the following is an example of positive nonverbal communication during a patient encounter?
• Capillary sampling is advised when veins are not palpable.
• Immediately before removing the needle, which action should the phlebotomist take?
• Which virus is identified as the most chronic bloodborne infection in the United States?
• If sudden swelling occurs at the venipuncture insertion site, which action should be taken?
• Which PPE is required as an additional precaution for measles exposure?
• Which POC laboratory test is within the CLIA defined scope of practice for a phlebotomist?
• A phlebotomist must collect type and screen, STAT electrolytes, D-dimer, and estrogen. Which of the following lists the additives in CLSI recommended order of draw?
• For a 24-hour urine collection, when does timing begin?
• Which of the following is an example of negative nonverbal communication?
• Which statement best describes the PPE used in the isolation scenario?
• For bilirubin specimen collection from a premature newborn, which device is BEST?
• When performing a venipuncture, the phlebotomist is stuck with a bloody needle upon withdrawal from the patient. What is the FIRST thing the phlebotomist should do?
• Which collection error is MOST likely to cause a specimen to appear critically high for a certain analyte?
• In hemolyzed samples, which analyte is falsely elevated?
• Which test monitors heparin therapy?
• If the patient is allergic to shellfish, any solution containing iodine is contraindicated. Which antiseptic should be avoided?
• Why is the aerobic blood culture tube drawn first when using a winged infusion set?
• What does the color of an evacuated blood collection tube represent?
• For which patient is the use of an adhesive bandage contraindicated after a blood draw?
• In a PT and CBC collection, which sequence of evacuated tube colors is correct?
• Why should venipuncture be avoided on an arm with a cast or splint?
• Which item is included in an exposure control plan?
• Which outcome is most directly addressed by keeping the stopper in place during processing?
• Which is the appropriate blood collection device for obtaining a blood spot collection on an infant?
• For a 17-month-old routine capillary draw to determine lead levels, the point of draw should be which site?
• Under CLIA, laboratory certificates are categorized based on which criterion?
• If a droplet of dried blood is found on the phlebotomy chair, what should the phlebotomist do?
• Which of the following tests is commonly transported on an ice slurry?
• Which action demonstrates compliance with Quality Control guidelines for phlebotomy?
• Exposure of evacuated blood specimens to freezing temperatures before analysis is most likely to affect which parameter?
• Which statement by a new phlebotomist indicates a need for further education on standard precautions?
• How should the phlebotomist prepare the skin for venipuncture of the median cubital vein?
• A patient with burns on both arms; which collection method yields the largest amount of blood?
• A phlebotomist must collect a specimen for a blood alcohol test on a patient who is allergic to shellfish. Which antiseptic should be used?
• For routine urine testing, which timing is commonly favored?
• A phlebotomist collects a cryofibrinogen specimen, places it in a biohazard bag, onto an ice slurry, and transports it to the laboratory promptly. In this case the phlebotomist
• According to room-temperature handling guidelines, choose the appropriate storage temperature.
• Which option is not a venipuncture technique?
• After the initial attempt went through the vein and blood was successfully collected, what should the phlebotomist do next?
• After centrifuging, the serum appears reddish. Which has occurred?
• What is the NEXT step when a STAT test has been ordered for the patient, but the patient is not in their room?
• Which of the following veins would generally be acceptable for routine blood collection by the phlebotomist?
• When transporting a specimen that requires room-temperature handling, which temperature is appropriate?
• Which color top tube is typically used for CBC in standard panel testing?
• Which action should the phlebotomist take to make a vein more prominent when selecting a venipuncture site?
• Which method is recommended for PKU neonatal screening blood collection in infants less than one year old?
• Chlorhexidine gluconate solutions may contain alcohol. Which antiseptic best reflects this property?
• Where should a phlebotomist look to find information about disposing of outdated hazardous chemicals?
• If scar tissue in the antecubital area prevents venipuncture, which is an appropriate alternative for obtaining a blood specimen?
• During a venipuncture, the phlebotomist forgets to remove the tourniquet before withdrawing the needle. What is the most likely result?
• Which additive is contained in the yellow SPS tube?
• The primary purpose of the Needlestick Safety and Prevention Act is to protect workers from exposure to
• Which collection tube requires site preparation with povidone iodine or chlorhexidine?
• Which statement best defines standard precautions?
• A phlebotomist may draw without physician approval from which site if the patient has an IV in the right arm and the left arm is inaccessible?
• A woman who becomes sensitized to the Rh factor can produce antibodies against which antigen?
• Most laboratory testing errors occur during which phase?
• Which two tubes are used for chemistry and coagulation testing in the correct order of draw?
• What is the reason for using the lateral heel instead of a finger when performing a capillary puncture on an infant?
• Which option best defines implied consent in phlebotomy?
• Which action should a phlebotomist take when disposing of a needle after a venipuncture?
• How does CLSI's capillary blood collection order differ from venipuncture order?
• Which temperature is acceptable for a specimen that requires transportation and handling at room temperature?
• An inpatient with left-sided mastectomy has a hematoma in the left arm and an active IV in the right arm. Which site for venipuncture is appropriate?
• When performing venipuncture on a patient who has had a left mastectomy, which site should be used?
• Capillary puncture is commonly used as an alternative when venipuncture is not feasible.
• What is the purpose of inverting an EDTA blood collection tube immediately after collection?
• Why is it important to follow a specific order of draw when collecting multiple specimens?
• In the CLSI recommended order of draw for type and screen, STAT electrolytes, D-dimer, and estrogen, which additive is listed second?
• Commitment to privacy, continuity of care, advance directives, and the authority to refuse treatment are granted according to which of the following?
• In a CBC and BMP collection where the serum tube did not fill but PST and EDTA filled, what is the most likely reason the serum tube did not fill?
• Which site is preferred for capillary puncture in an infant?
• A STAT blood draw order indicates central port; what should the phlebotomist do NEXT?
• A tourniquet left on for an extended period of time before venipuncture is MOST likely to cause which outcome?
• Which department conducts microscopic analysis of urine to detect crystals, casts, bacteria, and blood cells?
• Using the guidelines for any method of venipuncture, which action should the phlebotomist perform FIRST?
• What is the proper method to clean up a broken glass tube?
• Which information is contraindicated for patient identification at the time of draw?
• Under CLIA, which levels of testing are outside the scope for phlebotomists?
• Small red spots near the tourniquet are most likely indicative of which condition?
• Which of the following tests requires protection from light during transport?
• Why is the arm elevated during venipuncture when bleeding is ongoing?
• During palpation of a large vessel in the forearm, the phlebotomist detects a vibration sensation. Which is the best next step?
• Which temperature setting is suitable for specimens expected to be kept at ambient conditions?
• Which antiseptic should be avoided in shellfish-allergic patients when selecting a prep solution for venipuncture?
• The inner surface of some plastic tubes can slow clotting because it inhibits what?
• During venipuncture with evacuated tubes, a small amount of blood enters the tube and then stops. Which condition is most likely the cause?
• Failing to wash hands properly violates which standard?
• Which urine specimen timing is described as ideal for many analyses?
• What form of consent must be obtained prior to venipuncture for an HIV diagnostic test?
• What is the maximum amount of time a phlebotomist can leave a tourniquet secured in place prior to venous access?
• Which tube color contains ACD additive?
• After which activity is it appropriate to use only an alcohol-based hand rub for hand hygiene?
• During venipuncture, the bevel should be in which position relative to the vein?
• Which of the following is a requirement for a healthcare facility to be in compliance with OSHA?
• Which statement best describes consent in emergencies when a patient cannot respond?
• Endocarditis refers to an infection of which cardiac structure?
• During a bed safety scenario, a potential liability arises from forgetting to do what?
• What is the most common site to draw an arterial blood collection?
• Which action is a HIPAA violation?
• What is the effect of applying warm moist heat to a venipuncture site?
• Which technique should the phlebotomist use when performing a venipuncture on a geriatric patient with loose skin?
• Which of the following needle gauges is MOST commonly used for venipuncture?
• Venipuncture should be avoided on an arm with:
• Capillary blood specimens are MOST likely to be successfully collected from patients who are
• What is the proper hand hygiene practice after finishing a venipuncture procedure?
• In capillary blood collection, which component is drawn first according to CLSI?
• Drawing blood from a vein below an IV site can cause which of the following issues?
• Which of the following is the minimum PPE requirement when drawing lab work on a patient with suspected HIV?
• Needle safety devices must
• Where should a phlebotomist collect blood for newborn screening?
• What is the primary purpose of using a butterfly needle in venipuncture?
• Which timing is regarded as ideal for urine collection in many analyses?
• Which needle gauge is recommended to minimize hemolysis during blood collection?
• What is the normal color of serum?
• Which organization makes on-site visits to inspect phlebotomy laboratories?
• When collecting serum, if the serum tube does not fill, which is the most likely reason?
• Standard precautions require PPE when dealing with potential contact with blood and body fluids.
• Hemolysis in a blood sample typically leads to a decrease in which parameter?
• Which specimen is ideal for most urine tests?
• To reduce the risk of patient injury during venipuncture, what safety practice regarding the bed rail is recommended?
• Keeping contaminated equipment away from clothing to prevent pathogen transmission is an example of which?
• During venipuncture, if the patient faints, what should the phlebotomist do first?
• Which tube and additive combination should be used for a PT/INR test?
• A phlebotomist has active symptoms of the common cold. Under which conditions may he perform venipuncture?
• For a capillary blood collection from a toddler, which finger is preferred?
• Which statement represents correct patient identification for a phlebotomist in an outpatient setting?
• For newborn screening capillary collection, which device is recommended?
• Venipuncture should be avoided on an arm with which condition?
• Which color tube is typically used for chemistry testing (plasma)?
• Which is an appropriate draw site for an adult patient with a central line?
• Which of the following describes the correct precautions for a patient with active pulmonary tuberculosis in a healthcare setting?
• Which condition can result if a tourniquet remains in place on the patient’s arm for longer than 60 seconds?
• What is the liquid portion of a clotted blood specimen?
• When should a test tube be labeled with the patient's identification?
• For room-temperature handling, which temperature is appropriate?
• Which should be used to secure the 2 x 2 gauze sponge on an elderly patient with skin tears?
• Which of the following would be considered a hospital acquired infection?
• Which action is appropriate for ensuring chain-of-custody documentation for blood alcohol testing?
• When inspecting a patient’s arm before venipuncture, the back of the hand is the most desirable site. Which venipuncture method is most appropriate in this scenario?
• Which regulation sets the minimum standards for medical laboratory practice and quality?
• Which post-venipuncture action should be avoided to reduce the risk of a hematoma?
• Which task should a phlebotomist complete prior to daily use of a POCT instrument?
• To help prevent a hematoma at the site after drawing blood, which of the following actions should the phlebotomist take?
• If a bruise occurs after a venipuncture where the needle went through the vein, which instruction is appropriate to give the patient?
• After selecting the appropriate location to collect a blood sample, how many inches above that location should the phlebotomist tie the tourniquet?
• The Needlestick Safety and Prevention Act exists to protect healthcare workers from accidental exposure to which?
• How should an ammonia level specimen be transported to minimize metabolism and evaporation?
• Which color tube is typically used for CBC testing in the order CBC, PT, and BUN?
• Which vein would generally be avoided for routine blood collection in the arm?
• How can you tell a needle is in the vein?
• Which option is an example of quality control documentation in phlebotomy?
• The proper technique to anchor a vein is to use the non-dominant thumb
• Which statement explains why the first drop of blood is wiped away during capillary puncture?
• The phlebotomist educates a patient on fasting prior to a glucose tolerance test. What is the minimum fasting duration before the test begins?
• A phlebotomist has orders to collect blood from a patient who has IVs in the right forearm and the left antecubital area. Where should the phlebotomist collect a venous blood specimen?
• If bleeding does not stop after two minutes of applying pressure, which action is next?
• The phlebotomist is performing a venipuncture on an apprehensive school-age child. Which approach should be used to calm the child?
• In capillary blood collection, which component is drawn third according to CLSI?
• Which tube should be collected for a coagulation study such as PT/INR in a patient on coumadin therapy?
• Which of the following is an example of a pre-analytical error made at the time of collection?
• The rubber sleeve at the end of an ETS venipuncture needle allows for which of the following?
• Acidosis is most commonly the result of which of the following?
• Negligence by a health care professional is called what?
• Which specimen type is primarily used to perform CLIA-waived point-of-care testing for glucose?
• After performing a venipuncture on a patient the phlebotomist notices the patient is bending his elbow to hold the gauze in place. This action is contraindicated because bending the elbow is likely to
• Which QC measure is within the phlebotomist's scope of practice?
• A 19-year-old patient offers her arm to the phlebotomist for venipuncture. This is an example of which consent?
• Which issue is prevented by leaving stoppers on tubes during centrifugation?
• Which statement best describes why red-top tubes are used for serum testing?
• A phlebotomist is asked to collect a cold agglutinin specimen. The specimen should be
• In a multi-tube venipuncture draw, if a second tube fails to fill and adjusting the needle doesn't help, what is the next best step?
• Which collection device is often preferred for patients with smaller or fragile veins, including elderly and small children?
• Which site preparation solution is required for collecting blood cultures and blood alcohol levels?
• Chain-of-custody documentation is typically required for which type of laboratory testing?
• Why should you release the tourniquet as soon as blood flow is established?
• Which combination of precautions is appropriate for a patient with active pulmonary tuberculosis?
• Which action can lead to liability issues during phlebotomy?
• Which infection is considered the most chronic bloodborne illness in the United States?
• The phlebotomist is collecting a capillary sample from an infant. Following the collection, the phlebotomist holds firm pressure on the site until bleeding has stopped. How should the phlebotomist proceed?
• Federal law requires hepatitis B vaccination to be made available to employees with occupational exposure risk within how many working days after assignment?
• The physician has ordered a prothrombin time (PT) and complete blood count (CBC) for an adult patient with thrombophlebitis. The phlebotomist should collect the evacuated tubes in which of the following orders?
• What is the primary reason for keeping the stopper on during centrifugation?
• How long should pressure be applied on the venipuncture site for a patient on Coumadin therapy?
• Light blue-topped tubes are used primarily for which type of testing?
• During a venipuncture, the patient experiences a seizure. Which action should be taken first?
• How long should the heel be warmed before capillary blood collection?
• Stoppers should be left on tubes awaiting centrifugation to prevent
• Which tube is needed for coagulation testing?
• Endocarditis is best described as an infection of which part of the heart?
• For a two-year-old patient requiring Hct and Hgb testing, which site is appropriate for a dermal puncture?
• Which of the following rights is included in The Patient's Bill of Rights?
• Which statement about swallowing water during fasting for certain tests is accurate?
• Gray-top tubes (sodium fluoride) are primarily used for which type of testing?
• Which step is completed FIRST in performing venipuncture?
• If a patient has measles, which of the following is a required additional precaution?
• Plastic red-top tubes used to collect blood specimens usually contain
• For capillary blood sampling on a six-month-old infant's heel, what is the maximum lancet depth recommended?
• After a patient jump caused a contaminated needle-stick, after thorough hand washing, what should the phlebotomist do FIRST?
• Gray-topped sodium fluoride tubes should not be used to collect ALT or AST because the anticoagulant
• If a Rh-negative woman is exposed to Rh-positive fetal blood, what is the typical immunologic consequence?
• Which vein is commonly used for venipuncture in the antecubital fossa and is often preferred for routine blood draws?
• Which action should the phlebotomist take to decrease the potential for hemolysis of a blood specimen in an EDTA tube?
• When drawing a blood alcohol specimen, which should be used to clean the arm?
• An infant is brought to the clinic for a CBC. After performing a heel stick, not enough blood is collected to perform the test. Which action should the phlebotomist take?
• A requisition is to draw a bilirubin on an infant with jaundice. The phlebotomist should
• Which statement about emergencies and consent is correct?
• Which statement best describes the reason to keep stoppers on during centrifugation?
• A centrifuge functions in which of the following ways?
• Which equipment is MOST appropriate for drawing a CBC from a 5-year-old patient?
• For capillary blood sampling in a patient with a left arm AV shunt and a history of right mastectomy, which finger should be used?
• When drawing multiple tests that include a blood culture, which container is typically filled first?
• Forceful shaking of an evacuated collection tube will cause which complication?
• Which blood vessel carries oxygenated blood?
• Which statement indicates the need for further education on pre-test restrictions to ensure accuracy of results?
• Which collection method is best for fragile veins, minimizing vein trauma?
• Failure to provide a translator for a Spanish-speaking patient, when requested, would be considered a violation of which document?
• A physician orders a hemoglobin test for a 2-month-old patient. Which site is appropriate for obtaining the specimen?
• A sharp may be disposed of following a venipuncture once the needle is
• Which department performs blood cultures?
• Which tube is commonly used for hematology testing such as CBC?
• While performing a venipuncture in the antecubital space, the patient verbalizes an extreme amount of pain and the blood in the collection tube is noted to be bright red. Which of the following sites is MOST likely to have been inadvertently punctured?
• Which test is used as a screening test for glucose metabolism problems?
• What is the correct method for transferring blood from a syringe into evacuated tubes?
• A phlebotomist must follow transmission based precautions for which of the following patients?
• For an older adult with veins that repeatedly collapse despite hydration, which collection method is best?
• Why is hand decontamination after glove removal essential?