Phlebotomy Practice Test 2: 30 More Free Questions
Thirty new exam-style questions, none of them repeated from Practice Test 1. Most are short scenarios, and there are more on safety, OSHA rules and patient identification than on tube colors, because students report that is what the real exams lean on. Weighted to the NHA CPT test plan. Tap an answer to see whether you got it right, why each wrong option is wrong, and the standard the answer comes from. Then go on to Practice Test 3.
Written by Benjamin Tibbs, a phlebotomy studentChecked against CLSI, OSHA, CDC and The Joint CommissionUpdated October 2026
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Answer: A. HIV post-exposure prophylaxis works best when started within hours
CDC guidance is that HIV post-exposure prophylaxis, when it is indicated, should start as soon as possible, ideally within hours and no later than 72 hours after the exposure. Reporting immediately starts the employer's post-exposure evaluation and follow-up under OSHA 29 CFR 1910.1030(f)(3), including source-patient testing once consent is obtained and hepatitis B follow-up.
Why the other choices are wrong
- B. OSHA's standard places the duties on the employer. The urgency is medical: prophylaxis works best when started early.
- C. Source testing is done as soon as feasible after consent, not within a fixed 15 minutes.
- D. A needlestick rarely needs stitches. The urgency is the post-exposure evaluation and possible prophylaxis.
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Answer: B. Label the spray bottle with the product name and its hazards
Under 29 CFR 1910.1200(f)(6), workplace containers of hazardous chemicals must be labeled with the product identifier and words, pictures or symbols that convey the hazards. The exemption in (f)(8) covers only portable containers meant for the immediate use of the employee who filled them, so a bottle used across shifts must be labeled.
Why the other choices are wrong
- A. Staying in the same room is not an exemption. Only a container for the immediate use of the person who filled it is exempt.
- C. A date tells no one what the chemical is or how it can hurt them.
- D. The SDS must be accessible in the work area, but it does not replace the container's label.
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Answer: C. Talk later in private, and only if work requires it
HIPAA requires reasonable safeguards to limit incidental disclosures (45 CFR 164.530(c)), and staff share only what their job needs (the minimum necessary standard, 45 CFR 164.502(b)). Patients are not discussed in elevators, cafeterias or hallways where others can overhear. If the coworker has a work reason to know, they talk in a private area.
Why the other choices are wrong
- A. Speaking quietly in a crowded elevator still discloses patient information to bystanders.
- B. A first name together with a room and a problem identifies the patient.
- D. Bystanders already heard the room number in the question, and details of a patient's care are protected health information.
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Answer: D. Disposable gloves are never cleaned for reuse
OSHA 29 CFR 1910.1030(d)(3)(ix)(B) states that disposable (single-use) gloves shall not be washed or decontaminated for re-use. A new pair is used for each patient, and hand hygiene is done after removing them, as CDC hand hygiene guidance also directs.
Why the other choices are wrong
- A. The alcohol content does not matter: OSHA forbids decontaminating disposable gloves for reuse.
- B. The rule applies to every patient in every setting.
- C. Contamination is often invisible. Single-use gloves are discarded after each patient regardless of how they look.
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Answer: A. PPE must be removed before leaving the work area
OSHA 29 CFR 1910.1030(d)(3)(vii) requires all personal protective equipment to be removed before leaving the work area and placed in a designated container for laundering, decontamination or disposal. Wearing it into the cafeteria carries contamination into a public area. An isolation gown is also removed before leaving the patient's room.
Why the other choices are wrong
- B. All PPE comes off before leaving the work area, gowns included. A gown carries contamination as easily as gloves do.
- C. Contamination is not always visible, and the rule applies to all PPE regardless.
- D. Turning a gown inside out does not make it acceptable outside the work area. It is removed and discarded.
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Answer: B. The employer launders it at no cost to the employee
Under 29 CFR 1910.1030(d)(3)(iv), the employer cleans, launders and disposes of required personal protective equipment at no cost to the employee. Contaminated laundry is bagged where it was used and handled as little as possible ((d)(4)(iv)), so blood-soiled protective clothing never goes home.
Why the other choices are wrong
- A. Home laundering of contaminated protective clothing is what the standard prevents. The employer launders it.
- C. Rinsing contaminated clothing by hand agitates it and risks splashes. It is bagged as contaminated laundry instead.
- D. A garment penetrated by blood is removed immediately or as soon as feasible ((d)(3)(vi)), not worn for days.
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Answer: C. Never mix them: together they give off toxic gas
Bleach (sodium hypochlorite) mixed with ammonia releases toxic chloramine gases that can cause coughing, shortness of breath and lung damage. Bleach labels and Safety Data Sheets warn never to mix it with ammonia or acids. Disinfectants are used alone, at the dilution and contact time on the label.
Why the other choices are wrong
- A. Ventilation does not make chloramine gas safe. The two chemicals are never mixed.
- B. Water does not stop the reaction that produces the gas.
- D. The reaction and the gas are the same wherever the mixture is used.
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Answer: D. In the employer's written exposure control plan
OSHA 29 CFR 1910.1030(c)(1) requires every employer with occupationally exposed employees to have a written exposure control plan, including the procedure for evaluating exposure incidents. It must be accessible to employees and reviewed and updated at least annually.
Why the other choices are wrong
- A. The plan must be accessible to employees, not tucked into a handbook from their first day.
- B. Safety Data Sheets cover chemical hazards, not bloodborne pathogen exposures.
- C. A sharps container label only marks the contents as biohazardous.
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Answer: A. Use only latex-free gloves, tourniquet and bandage
Latex allergy can cause anything from a rash to anaphylaxis. Everything that touches the patient (gloves, tourniquet, bandage, tape) must be latex-free, and latex products are kept away from her, because powder from latex gloves can carry latex proteins through the air (NIOSH).
Review: Patient Identification
Why the other choices are wrong
- B. Latex gloves touch her skin throughout the draw, and their proteins can trigger a reaction.
- C. A reaction can follow brief contact, and severe reactions can be life threatening.
- D. Gauze does not reliably block latex proteins, and the other items would still contain latex.
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Answer: B. At least 8 hours
The American Diabetes Association's Standards of Care define fasting, for a fasting plasma glucose, as no caloric intake for at least 8 hours. Plain water is allowed. If the patient has eaten within that time, the specimen is not a fasting specimen, and that is documented or the provider is told per facility policy.
Review: Patient Identification
Why the other choices are wrong
- A. Four hours is shorter than the 8-hour fast ADA defines for a fasting plasma glucose.
- C. Sixteen hours is longer than the definition requires.
- D. A 24-hour fast is not required and could make some patients hypoglycemic.
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Answer: C. In a drawing chair with arms that prevent a fall
Patients are drawn in a stable chair with armrests (or lying down), so a patient who faints is held in place instead of falling. A stool, the edge of an exam table, or standing all leave nothing to stop a fall.
Review: Patient Identification
Why the other choices are wrong
- A. A rolling stool has no arms or back and can roll away under a fainting patient.
- B. A patient who faints on the edge of an exam table can fall to the floor.
- D. A patient who faints while standing falls from full height.
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Answer: D. Face her and speak clearly, writing as needed
For a patient who reads lips, face her in good light and speak clearly at a normal pace, and use writing or a qualified sign language interpreter when needed; the Americans with Disabilities Act requires effective communication. She is entitled to the same explanation as anyone else before she consents.
Review: Patient Identification
Why the other choices are wrong
- A. Volume does not help a deaf patient, and she cannot read lips from behind.
- B. Every patient is entitled to an explanation before consenting. Skipping it undermines her consent.
- C. The patient, not her companion, consents to the procedure, and sharing her information with others needs her agreement.
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Answer: A. Match two identifiers on his wristband to the requisition
When a patient cannot state identifiers, two identifiers on the attached wristband (such as full name and medical record number or birth date) are matched to the requisition, and many facilities add confirmation by the patient's nurse. A room number is never an identifier, and a confused patient may answer to any name.
Review: Patient Identification
Why the other choices are wrong
- B. Room and bed numbers are never identifiers; patients move.
- C. A confused patient may answer to any name.
- D. Another patient is not an acceptable source of identity, and asking discloses information about the patient.
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Answer: B. Say his provider is the right person to explain the tests
Explaining why tests were ordered or what results mean is the provider's role. The phlebotomist explains the collection itself and refers questions about diagnosis, reasons for testing and results to the provider. Guessing or reassuring can mislead a worried patient.
Review: Patient Identification
Why the other choices are wrong
- A. Explaining what tests may mean for his diagnosis is outside the phlebotomist's scope of practice.
- C. False reassurance can mislead him; the phlebotomist does not know the results.
- D. That leaves an anxious patient to interpret tests without his provider's context.
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Answer: C. Clean the site again and let it air-dry before the puncture
Repalpating after cleansing contaminates the site. If the vein must be touched again, the site is cleansed again and allowed to air-dry completely before the needle goes in. Fanning or blowing on the site also contaminates it.
Why the other choices are wrong
- A. Speed does not undo the contamination that has already happened.
- B. Cleaning the glove does not clean the skin it already touched.
- D. Blowing on the site adds organisms. The site should air-dry.
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Answer: D. Tourniquet first, then the needle, then pressure
The tourniquet is released before the needle is withdrawn. If the needle comes out while the tourniquet is still on, the vein is under pressure, blood is forced out through the puncture, and a hematoma forms. Then apply pressure with gauze.
Why the other choices are wrong
- A. With the tourniquet still on, the vein is under pressure as the needle comes out, so blood escapes into the tissue.
- B. The tourniquet must already be off when the needle comes out, or the pressurized vein bleeds into the tissue.
- C. Leaving the tourniquet on after withdrawal keeps the vein pressurized and causes a hematoma.
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Answer: A. Basilic vein
The median cubital vein is the first choice and the cephalic the second. The basilic vein, on the inner (medial) side of the arm, is last because it runs close to the brachial artery and the median nerve, and it tends to roll and bruise.
Why the other choices are wrong
- B. The cephalic vein is the second choice, after the median cubital.
- C. The median cubital is the first choice: well anchored and away from major nerves and arteries.
- D. They are not equal: the basilic carries the highest risk of nerve and arterial injury.
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Answer: B. Ask another phlebotomist to attempt the draw
Following CLSI guidance, facilities limit a phlebotomist to two unsuccessful attempts on a patient. After that, another qualified phlebotomist tries, or the nurse or provider is notified per policy. Repeated sticks add pain and risk of injury.
Why the other choices are wrong
- A. A third attempt by the same person goes against the two-attempt limit.
- C. Unlimited attempts injure the patient; the limit exists for the patient's safety.
- D. The phlebotomist does not cancel orders. The nurse or provider is told if the draw cannot be done.
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Answer: C. The site may bleed longer, so hold pressure longer
Petechiae under a tourniquet can signal fragile capillaries or a platelet or clotting problem. The draw can go ahead, but the site may bleed longer afterward, so pressure is held until bleeding has stopped completely before the bandage goes on.
Why the other choices are wrong
- A. Petechiae are small bleeds under the skin. They do not hemolyze the specimen in the tube.
- B. Tourniquet petechiae are not an allergy; an allergic reaction looks like a rash or hives.
- D. Petechiae are tiny skin hemorrhages and say nothing about the vein collapsing.
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Answer: D. 21 gauge
Gauge numbers run opposite to size: the higher the number, the smaller the bore. Of these, 21 gauge, the standard for routine adult venipuncture, is the largest. A 25-gauge needle is so fine that it raises the risk of hemolysis.
Why the other choices are wrong
- A. 25 gauge is the smallest bore listed. Higher gauge numbers mean smaller needles.
- B. 23 gauge is smaller than 21 or 22 gauge; it is used for small veins, often with a butterfly.
- C. 22 gauge is slightly smaller than 21 gauge.
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Answer: A. Release it, wait about 2 minutes, then reapply it
A tourniquet left on longer than 1 minute causes hemoconcentration, which changes results such as potassium, total protein and cell counts. The guidance is to release it and wait about 2 minutes before reapplying it for the draw.
Why the other choices are wrong
- B. Prolonged tourniquet time changes the specimen through hemoconcentration.
- C. Tightening increases hemoconcentration and can cut off arterial flow.
- D. A loosened tourniquet still slows venous return. Release it and reapply after about 2 minutes.
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Answer: B. To keep tube additive from flowing back into the vein
With the arm downward and the tube below the site, each tube fills from the bottom up, so blood in contact with the additive cannot flow back from the tube into the vein. This prevents reflux of additive into the patient, which can cause adverse reactions.
Why the other choices are wrong
- A. Fill speed is set by the tube's vacuum and the needle. The position is about preventing reflux.
- C. Air bubbles are not the concern; reflux of additive into the vein is.
- D. Arm position has nothing to do with the tourniquet staying in place.
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Answer: C. Wipe them with 70% isopropyl alcohol and let them dry
The septum under a flip-off cap is not guaranteed sterile, so blood culture bottle manufacturers (BD BACTEC) direct wiping it with 70% isopropyl alcohol and letting it dry before inoculation. Iodine is not used on the septum because it can damage the rubber.
Why the other choices are wrong
- A. The cap protects the septum but does not guarantee it is sterile. It is disinfected before inoculation.
- B. Iodine is not recommended on the bottle septum; it can damage the rubber.
- D. Water does not disinfect. The septum is wiped with 70% isopropyl alcohol.
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Answer: D. With a warm compress, below 42 °C, for 3 to 5 minutes
CLSI GP42-Ed7 recommends warming the heel with a warm compress or commercial heel warmer at no more than 42 °C for 3 to 5 minutes. That increases blood flow to the site considerably without burning the infant's thin skin.
Why the other choices are wrong
- A. High heat for a long time can burn an infant's thin skin.
- B. Rubbing with alcohol does not warm the heel, and the site must be dry before the puncture.
- C. Hot tap water can scald an infant and is not a controlled temperature.
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Answer: A. That its temperature is 32–38 °C (90–100 °F)
Under 49 CFR 40.65, the collector checks the specimen's temperature no later than 4 minutes after receiving it; the acceptable range is 32–38 °C (90–100 °F). The collector also checks that there are at least 45 mL. A temperature outside the range suggests a substituted or adulterated specimen, and the rule then requires an immediate new collection under direct observation (or an oral fluid collection).
Why the other choices are wrong
- B. pH is tested by the laboratory, not checked by the collector at the collection site.
- C. Clarity is not one of the required collection-site checks.
- D. Blood pressure plays no part in a urine drug test collection.
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Answer: B. Across (perpendicular to) the fingerprint lines
CLSI GP42-Ed7 calls for the puncture on the fleshy pad of the fingertip, slightly off center and across the fingerprint lines, so the blood forms a round drop. A cut parallel to the lines lets the blood run along the grooves, which makes collection difficult.
Why the other choices are wrong
- A. A cut parallel to the lines lets blood run down the grooves instead of forming a drop.
- C. The very tip is close to the bone. The puncture is on the fleshy pad, slightly off center.
- D. The side of the finger and the area near the nail are avoided. The fleshy pad is used.
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Answer: C. Wait until the rotor stops completely, then open it
A centrifuge lid is opened only after the rotor has stopped completely. Opening it early or braking the rotor by hand can injure the hand and release aerosols from a broken or leaking tube (CDC/NIH, Biosafety in Microbiological and Biomedical Laboratories).
Why the other choices are wrong
- A. Never touch a moving rotor. It can injure the hand and stir up aerosols from any broken tube.
- B. The timer ending does not mean the rotor has stopped.
- D. Unplugging does not make it safe to open the lid. Wait for the rotor to stop.
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Answer: D. Reject it and request a new specimen
Red cells contain far more potassium than serum, so hemolysis releases potassium into the serum and falsely raises the result. A visibly hemolyzed specimen for potassium is rejected and recollected, following the laboratory's hemolysis acceptance criteria.
Why the other choices are wrong
- A. The potassium would be falsely high, and reporting it could lead to wrong treatment.
- B. There is no reliable standard correction for hemolysis.
- C. Diluting does not remove the potassium released from the cells.
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Answer: A. Upright, stopper end up
Tubes are transported upright with the stopper up. This helps serum tubes clot completely, keeps blood off the stopper (reducing aerosols when it is opened), and limits agitation that can hemolyze the cells.
Why the other choices are wrong
- B. Lying flat leaves blood against the stopper and can interfere with complete clotting.
- C. Upside down puts blood against the stopper and can disturb clotting and the gel.
- D. Position matters for clotting and safety even when the tube is bagged.
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Answer: B. Right away, since the blood will not clot
Anticoagulated tubes (heparin, EDTA, citrate) yield plasma, so there is no clotting step: once mixed, they can be centrifuged right away. That is one reason plasma is used for STAT chemistry. Serum tubes must clot first, about 30 minutes in a clot-activator tube.
Why the other choices are wrong
- A. The 30-minute wait applies to serum tubes, which must clot before centrifugation.
- C. Waiting 2 hours delays a STAT result, and the cells keep changing the specimen while it sits.
- D. Electrolyte specimens are not chilled; cold makes potassium leak out of the cells.
Where these answers come from
Each question was checked against the standard named in its explanation. The sources used in this set:
- 49 CFR 40.65 (DOT urine specimen collection: temperature and volume)
- American Diabetes Association, Standards of Care in Diabetes (diagnosis: fasting plasma glucose)
- Americans with Disabilities Act, effective communication (28 CFR 35.160 and 36.303)
- BD BACTEC blood culture collection instructions (septum: 70% isopropyl alcohol, no iodine)
- BD Vacutainer tube instructions (plasma tubes may be centrifuged immediately; serum tubes clot 30 minutes)
- CDC/NIH, Biosafety in Microbiological and Biomedical Laboratories (centrifuge safety); manufacturer instructions
- CDC/USPHS occupational post-exposure prophylaxis guidance; OSHA 29 CFR 1910.1030(f)(3)
- CLSI GP42-Ed7 (fingerstick technique)
- CLSI GP42-Ed7 (warming the puncture site)
- CLSI PRE02-Ed8 (complications: petechiae and prolonged bleeding)
- CLSI PRE02-Ed8 (needle selection)
- CLSI PRE02-Ed8 (patient positioning)
- CLSI PRE02-Ed8 (preventing reflux)
- CLSI PRE02-Ed8 (site cleansing)
- CLSI PRE02-Ed8 (tourniquet release)
- CLSI PRE02-Ed8 (tourniquet time)
- CLSI PRE02-Ed8 (unsuccessful attempts)
- CLSI PRE02-Ed8 (vein selection)
- CLSI PRE04-Ed1 (specimen transport)
- HIPAA, 45 CFR 164.530(c) and 164.502(b)
- Laboratory specimen acceptance criteria (hemolysis interference with potassium); CLSI PRE04-Ed1
- NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace
- OSHA 29 CFR 1910.1030(c)(1)
- OSHA 29 CFR 1910.1030(d)(3)(iv), (d)(3)(vi) and (d)(4)(iv)
- OSHA 29 CFR 1910.1030(d)(3)(ix)(B); CDC hand hygiene in healthcare settings
- OSHA 29 CFR 1910.1030(d)(3)(vii); CDC 2007 Guideline for Isolation Precautions
- OSHA Hazard Communication Standard, 29 CFR 1910.1200(f)(6) and (f)(8)
- Phlebotomist scope of practice (NHA CPT test plan; AMT RPT content outline: professional communications)
- Sodium hypochlorite (bleach) Safety Data Sheet, Sections 7 and 10; OSHA Hazard Communication Standard
- The Joint Commission NPSG.01.01.01 (two patient identifiers)
More free practice tests
Every set has different questions, each with an explanation and your score by domain. No account needed.
By certification exam
General phlebotomy practice tests
Topic quizzes
The three phlebotomy certification exams
Question counts, time limits and passing scores from each certifying body's own documents, checked October 6, 2026.
| Exam | Questions | Time | Passing score | Practice |
|---|---|---|---|---|
| NHA CPTNational Healthcareer Association | 120 questions: 100 scored and 20 unscored pretest items | 2 hours | 390 (scaled score from 200 to 500) | NHA CPT practice exam |
| ASCP PBTAmerican Society for Clinical Pathology Board of Certification | 80 multiple-choice questions | 2 hours | 400 (scaled score) | ASCP PBT practice exam |
| AMT RPTAmerican Medical Technologists | 200 scored questions (AMT exams may also include unscored pretest items) | 2.5 hours | 70 (scaled score from 0 to 100) | AMT RPT practice exam |
More detail: how each exam is scored · retake rules · NHA vs ASCP vs AMT · all exam facts with sources
Clinical References
- CLSI PRE02-Ed8 — Collection of Diagnostic Venous Blood Specimens (8th ed., 2025)
- NHA CPT Exam Content Outline (2024)
- ASCP Board of Certification Content Guidelines
- OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)
- CDC Guidelines for Infection Control in Healthcare Settings