Phlebotomy Practice Test 3: 30 Free Exam Questions
Another thirty scenario questions, different from Practice Test 1 and Practice Test 2: OSHA recordkeeping, privacy, identification problems, labeling, special collections and processing, weighted to the NHA CPT test plan. No account needed. Tap an answer to see whether you got it right, why each wrong option is wrong, and the standard the answer comes from. Your score and weakest area appear at the end.
Written by Benjamin Tibbs, a phlebotomy studentChecked against CLSI, OSHA, CDC and The Joint CommissionUpdated October 2026
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Answer: B. The device type and brand, the work area, and how it happened
OSHA 29 CFR 1910.1030(h)(5)(i) requires the sharps injury log to record, at minimum, the type and brand of device involved, the department or work area where the exposure occurred, and an explanation of how it occurred, kept in a way that protects the injured employee's confidentiality. The log helps the employer evaluate safer devices.
Why the other choices are wrong
- A. The log must protect the employee's confidentiality. Personal details are not what it is for.
- C. The source patient's diagnosis is confidential and not part of the log. The device and the circumstances are.
- D. Source-patient information is not recorded in the sharps injury log.
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Answer: D. Engineering controls
29 CFR 1910.1030(b) defines engineering controls as controls, such as sharps disposal containers, self-sheathing needles and safer medical devices, that isolate or remove the bloodborne pathogens hazard from the workplace. Work practice controls change how a task is done (for example, never recapping), and PPE is what the worker wears.
Why the other choices are wrong
- A. Work practice controls change how a task is performed, such as not recapping needles.
- B. PPE is what the worker wears: gloves, gowns, face shields.
- C. Administrative controls are policies and scheduling. The standard names sharps containers and safety needles as engineering controls.
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Answer: A. Unplug it, tag it out of service, and report it
Damaged cords are a shock and fire hazard. OSHA 29 CFR 1910.334(a)(2)(ii) requires damaged portable electrical equipment to be removed from service, and no one may use it until it has been repaired and tested. Unplug it, tag it so no one else uses it, and report it.
Why the other choices are wrong
- B. Tape is not a safe repair for exposed wiring. The equipment must be repaired and tested first.
- C. Every use until then risks a shock or a fire.
- D. The size of the load has nothing to do with the electrical hazard.
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Answer: C. Finish safely, then remove the gloves, clean hands and re-glove
OSHA 29 CFR 1910.1030(d)(3)(ix)(A) requires disposable gloves to be replaced as soon as feasible when they are torn or punctured. With the needle in the vein, the safe course is to complete the draw, then remove the gloves, perform hand hygiene and put on a new pair.
Why the other choices are wrong
- A. Yanking the needle out mid-draw risks injuring the patient and losing the specimen. Replace the gloves as soon as it is safe.
- B. Torn gloves are replaced, and gloves are never worn from one patient to the next.
- D. Covering a torn glove does not replace it, and hand hygiene is still needed after the gloves come off.
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Answer: B. Use an antiseptic hand rub now, and wash with soap later
Where handwashing facilities are not feasible, OSHA 29 CFR 1910.1030(d)(2)(iv) requires an antiseptic hand cleanser with clean towels, or antiseptic towelettes, and hands are washed with soap and running water as soon as feasible afterward. CDC prefers alcohol-based hand rub whenever hands are not visibly soiled.
Why the other choices are wrong
- A. Hand hygiene after removing gloves cannot wait. Hands can be contaminated during removal.
- C. Water alone does not decontaminate hands.
- D. Gloves are not a substitute for hand hygiene, and new gloves over contaminated hands are contaminated too.
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Answer: D. A full-face photo is protected health information
Under the HIPAA Privacy Rule, a full-face photograph is one of the identifiers that make health information identifiable (45 CFR 164.514(b)(2)(i)(Q)), and an image of a patient in a care setting shows that they are receiving care. Posting it without the patient's written authorization is an impermissible disclosure, even with no name attached.
Why the other choices are wrong
- A. A face identifies a patient without any name.
- B. Deleting it later does not undo a disclosure that has already happened.
- C. The problem is the patient's privacy, not when the photo was taken.
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Answer: A. Complete an incident report as the facility requires
Any patient fall or injury is documented in an incident (occurrence) report under facility policy once the patient has been cared for. The report records facts, helps the facility prevent repeat events, and is not an admission of fault.
Why the other choices are wrong
- B. Minor injuries are reported too. An injury can show up later, and the report helps prevent the next fall.
- C. Asking a patient to sign a blame statement is improper. The report records facts only.
- D. Concealing an incident is unethical and undermines patient safety.
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Answer: C. The duration of employment plus 30 years
OSHA 29 CFR 1910.1030(h)(1)(iv) requires these medical records to be kept for at least the duration of employment plus 30 years, and they are kept confidential. Training records, by contrast, are kept for 3 years.
Why the other choices are wrong
- A. Far too short: illnesses from an exposure can appear years later.
- B. Three years is the retention period for training records, not medical records.
- D. The records cover the whole employment plus 30 years, wherever the employee works within the organization.
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Answer: B. Wait until the nurse puts an ID band on him
An inpatient is identified against an ID band attached to the patient. A band on a table could belong to anyone, so the nurse is notified to confirm identity and apply the band under facility policy before the draw. The phlebotomist does not attach the band.
Review: Patient Identification
Why the other choices are wrong
- A. A loose band is not attached identification; it may not be his.
- C. Attaching an ID band is done by the nurse or registration staff once identity is confirmed, not by the phlebotomist.
- D. A band on the bed rail identifies a bed, not the patient.
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Answer: D. It rises and falls daily, peaking in the morning
Cortisol has a diurnal (circadian) rhythm: it is highest in the early morning and falls through the day to its lowest around midnight. Results are interpreted against the time of collection, so the draw is done on time and labeled with the actual time.
Review: Patient Identification
Why the other choices are wrong
- A. Stability in the tube does not depend on the time of day.
- B. The timing is about the hormone's daily rhythm, not about food.
- C. The timing reflects the hormone's rhythm, not the laboratory's schedule.
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Answer: A. Come back later, unless the draw is STAT or timed
A routine draw can wait while a physician is with the patient: the phlebotomist returns later. If the draw is STAT or timed, they politely ask whether it can be done now. Recording it as refused would be false, because the patient did not refuse.
Review: Patient Identification
Why the other choices are wrong
- B. Interrupting an examination for a routine draw is unnecessary.
- C. A routine draw does not justify asking a physician to leave.
- D. The patient did not refuse. Recording a refusal creates a false record.
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Answer: C. Ask the patient to slip the arm out of the sleeve
A tight sleeve pushed up the arm acts like a second tourniquet: it slows venous return, adds to hemoconcentration, and keeps pressing after the tourniquet is released, which encourages bleeding and a hematoma. The patient takes the arm out of the sleeve (or changes into a gown) so nothing constricts it.
Review: Patient Identification
Why the other choices are wrong
- A. A tight sleeve is an uncontrolled tourniquet: it adds hemoconcentration and stays on after the real tourniquet is released.
- B. The sleeve still constricts the arm after the tourniquet is released, encouraging bleeding and a hematoma.
- D. Damaging the patient's clothing is unnecessary. Ask the patient to take the arm out of the sleeve.
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Answer: B. Tell the nurse and follow policy before drawing
Blood drawn after eating is not a fasting specimen; the ADA defines fasting as no caloric intake for at least 8 hours. The nurse is told (the provider may reschedule or change the order), and if the draw goes ahead it is labeled as non-fasting per facility policy.
Review: Patient Identification
Why the other choices are wrong
- A. Labeling an after-meal specimen as fasting falsifies how the result will be read.
- C. Eating raises blood glucose; that is why fasting is required.
- D. Half an hour is far short of the 8 hours that defines fasting.
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Answer: D. Ask the patient whether the visitors should step out
The patient decides who stays. HIPAA allows information to be shared with family who are present when the patient has had the chance to object and does not (45 CFR 164.510(b)). Asking respects the patient's privacy and dignity, and some patients find a family member comforting. Visitors who stay are asked to stand clear.
Review: Patient Identification
Why the other choices are wrong
- A. The patient may want family there. Asking first respects the patient's choice.
- B. Saying nothing denies the patient the chance to object to others hearing their information.
- C. The patient should have a chance to agree or object before their tests are discussed in front of others.
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Answer: A. Full name, ID number, date, time and your initials
Each tube is labeled at the bedside, in the patient's presence, right after collection, with at least the patient's full name and a unique identifier such as the medical record number, the date and time of collection, and the collector's initials or ID, per CLSI and facility policy.
Why the other choices are wrong
- B. A room number is never an identifier, and a label needs two patient identifiers.
- C. A diagnosis is not a label requirement, and the patient's identifiers are missing.
- D. A last name and birth year are not enough to tell patients apart.
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Answer: C. Cotton fibers stick and can pull the clot off
Cotton balls leave fibers in the forming clot; when the cotton is lifted away it can pull off the platelet plug and restart bleeding. Clean folded gauze is used to apply pressure instead.
Why the other choices are wrong
- A. Sterility is not the issue for applying pressure. The problem is fibers sticking to the clot.
- B. Gauze does not speed clotting; it avoids disturbing the clot.
- D. Cotton does not contain latex.
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Answer: B. 3 to 4 times
BD directs 3 to 4 gentle, complete inversions for citrate tubes, 5 for serum tubes, and 8 to 10 for heparin, EDTA and fluoride tubes. Gentle inversion mixes the citrate with the blood without damaging the cells.
Why the other choices are wrong
- A. Five inversions is BD's figure for serum and SST tubes.
- C. 8 to 10 inversions is for heparin, EDTA and fluoride tubes.
- D. An unmixed citrate tube can form small clots that ruin coagulation results.
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Answer: D. The vein in the left arm, avoiding the tattoo
Tattooed areas are avoided when another site is available, because of a higher risk of infection and possible interference from the dyes. A palpable vein matters more than a visible one, so the left antecubital vein is used.
Why the other choices are wrong
- A. Visibility is not the deciding factor. A good palpable vein elsewhere is preferred.
- B. Extra cleaning does not remove the reasons to avoid a tattoo.
- C. Guidance is to avoid tattoos when another site is available.
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Answer: A. Hold it lightly over the site, withdraw, then apply pressure
Gauze is held lightly over the site while the needle comes out, and pressure is applied only once the needle is fully withdrawn. Pressing on the needle as it comes out drags the bevel through the tissue, which hurts and can injure the vein. The arm stays straight while pressure is held.
Why the other choices are wrong
- B. Pressing on a needle as it is withdrawn drags it through the tissue and hurts the patient.
- C. Waiting lets blood leak onto the skin or into the tissue. Pressure goes on right away.
- D. Bending the elbow can disturb the clot and cause a hematoma.
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Answer: C. They may have lost vacuum, and the additive may have degraded
Tube manufacturers direct that tubes not be used after the expiration date. Vacuum is gradually lost, so tubes underfill and the blood-to-additive ratio is wrong, and additives can degrade. Expired tubes are discarded and stock is rotated so the oldest is used first.
Why the other choices are wrong
- A. Breakage is not the concern. Lost vacuum and degraded additive are.
- B. Stopper color is not what expiry affects.
- D. Expiry affects specimen quality, not billing.
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Answer: B. Around the wrist, just above the chosen hand vein
For a hand-vein draw the tourniquet goes around the wrist, proximal to (above) the chosen vein, so it sits a few inches above the site as it would for any venipuncture and makes the hand veins fill. It is applied gently, because hand veins are small and fragile.
Why the other choices are wrong
- A. The tourniquet goes a few inches above the chosen site. For a hand vein that means the wrist, not above the elbow.
- C. Fingers are never tourniqueted; it would cut off their circulation.
- D. Hand veins usually need a tourniquet to fill. It is applied at the wrist.
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Answer: D. Use an alternative, such as paper tape or a gauze wrap
Ask about adhesive sensitivity before bandaging. If the patient reacts to adhesive, use hypoallergenic paper tape or a self-adhering gauze wrap over the gauze. The site is always checked for bleeding first, and bending the elbow is not a substitute, because it can cause a hematoma.
Why the other choices are wrong
- A. A known reaction is avoided when an alternative exists.
- B. The site is checked for bleeding before the patient leaves.
- C. Bending the elbow can disturb the clot and cause a hematoma.
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Answer: A. From two separate venipuncture sites
Guidance from IDSA and the American Society for Microbiology calls for two or more blood culture sets, each from a separate venipuncture, collected before antibiotics are started. Separate sites help tell a true bloodstream infection (growing in both) from skin contamination (growing in one), and drawing before antibiotics improves recovery.
Why the other choices are wrong
- B. Two sets from a single puncture cannot tell a skin contaminant from a true infection.
- C. Drawing through an existing line raises contamination rates. Separate venipunctures are preferred.
- D. Antibiotics can keep organisms from growing, so cultures are drawn before the first dose.
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Answer: C. Flat at room temperature, away from heat, for at least 3 hours
CLSI NBS01 and state newborn screening programs direct drying the card horizontally at room temperature, away from heat and direct sunlight, for at least 3 hours, without stacking it or letting the spots touch anything. Heat, plastic bags and stacking damage or cross-contaminate the spots.
Why the other choices are wrong
- A. Heat damages the dried blood spots. Air-dry only.
- B. Sealing a wet card traps moisture and degrades the specimen.
- D. Cards are not stacked or hung vertically while drying; the spots can run or touch other cards.
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Answer: B. No, because bandages are a choking hazard under age 2
CLSI GP42-Ed7 advises against adhesive bandages on infants and children under 2 years, because a bandage can come loose and be swallowed or inhaled, and the adhesive can irritate or tear delicate skin. Check that bleeding has stopped and leave the site uncovered.
Why the other choices are wrong
- A. A bandage creates a choking risk for a young child. The site is checked and left uncovered once bleeding stops.
- C. Any bandage can come loose and end up in the child's mouth; size does not remove the hazard.
- D. Infants can bleed after a heel stick, so the site is checked until it stops.
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Answer: D. With its actual collection time and draw number
Glucose tolerance results are read against the time elapsed since the glucose drink, so each tube is labeled with its actual collection time and which draw it is (fasting, 1 hour, 2 hours and so on), along with the patient identifiers. Without that, the results cannot be put in order or interpreted.
Why the other choices are wrong
- A. Every tube would look the same. The individual times are what make the results interpretable.
- B. Each tube needs its own collection time.
- C. The order shows the planned times, not when each specimen was actually drawn.
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Answer: A. Reject them and request a properly labeled recollection
An unlabeled specimen cannot be traced to a patient with certainty, so routine blood specimens that arrive without labels are rejected and recollected. Labeling them later, away from the patient, risks attaching the wrong identity, which can cause a wrong-patient result or a transfusion error.
Why the other choices are wrong
- B. Labeling away from the patient cannot confirm whose blood is in the tube.
- C. A requisition traveling with the tubes does not prove they came from that patient.
- D. Room numbers are never identifiers, and the specimens' identity is unknown.
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Answer: C. Use a transfer pipette and label each aliquot to match
Aliquots are made with a disposable transfer pipette, not by pouring, which risks splashes and carrying over cells. OSHA requires procedures that minimize splashing (29 CFR 1910.1030(d)(2)(xi)). Each aliquot tube is labeled with the same patient identifiers as the original, plus the specimen type, and serum is never poured back.
Why the other choices are wrong
- A. Pouring risks splashes and can carry cells over from the clot or gel.
- B. Unlabeled aliquots are easily mixed up. Each one is labeled as it is made.
- D. Returning serum to the original tube risks contamination and confuses volumes.
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Answer: B. It forms a barrier between the serum and the cells
During centrifugation the gel settles between the heavier cells and the lighter serum, forming a barrier that keeps the serum from contact with the cells. The tube's clot activator (silica), not the gel, speeds clotting.
Why the other choices are wrong
- A. Clotting is sped up by the tube's clot activator, not by the gel.
- C. Sodium fluoride in a gray top inhibits glycolysis. The gel only separates serum from cells after centrifugation.
- D. An SST is a serum tube: it is designed to clot.
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Answer: D. Keep it as mixed whole blood; do not spin it
A CBC counts cells in whole blood, so the EDTA tube is not centrifuged, separated or frozen. It is kept as whole blood within the laboratory's stability limits and mixed again before analysis. Freezing would rupture the cells.
Why the other choices are wrong
- A. Centrifuging separates the cells the CBC needs to count in whole blood.
- B. Freezing ruptures blood cells and destroys the specimen for a CBC.
- C. Removing the plasma changes the whole-blood specimen the CBC requires.
Where these answers come from
Each question was checked against the standard named in its explanation. The sources used in this set:
- American Diabetes Association, Standards of Care (fasting definition); CLSI PRE02-Ed8
- BD Vacutainer SST product information
- BD Vacutainer order of draw and mixing guide
- BD Vacutainer tube instructions for use (do not use after expiration date)
- CLSI GP42-Ed7 (post-puncture care in infants and young children)
- CLSI NBS01 (dried blood spot collection); state newborn screening program instructions
- CLSI PRE02-Ed8 (approaching the patient); facility phlebotomy procedure
- CLSI PRE02-Ed8 (bandaging and post-puncture care)
- CLSI PRE02-Ed8 (labeling in the patient's presence); laboratory specimen rejection policy
- CLSI PRE02-Ed8 (labeling timed specimens); laboratory OGTT procedure
- CLSI PRE02-Ed8 (needle removal and post-puncture care)
- CLSI PRE02-Ed8 (post-puncture care)
- CLSI PRE02-Ed8 (preparing the site; hemoconcentration)
- CLSI PRE02-Ed8 (site selection: areas to avoid)
- CLSI PRE02-Ed8 (specimen labeling); The Joint Commission NPSG.01.01.01
- CLSI PRE02-Ed8 (tourniquet application; hand veins)
- Facility incident reporting policy; The Joint Commission patient safety event reporting
- HIPAA, 45 CFR 164.510(b) (involvement of family when the patient is present)
- HIPAA, 45 CFR 164.514(b)(2)(i)(Q) and 164.508 (authorization)
- IDSA/ASM Guide to Utilization of the Microbiology Laboratory (2018), blood cultures
- Laboratory test directory specimen requirements for a CBC (EDTA whole blood, not centrifuged)
- MedlinePlus, Cortisol test (diurnal variation)
- OSHA 29 CFR 1910.1030(b) (definition of engineering controls)
- OSHA 29 CFR 1910.1030(d)(2)(iv); CDC hand hygiene in healthcare settings
- OSHA 29 CFR 1910.1030(d)(2)(xi); CLSI PRE04-Ed1 (aliquoting)
- OSHA 29 CFR 1910.1030(d)(3)(ix)(A)
- OSHA 29 CFR 1910.1030(h)(1)(iv) and (h)(2)(ii)
- OSHA 29 CFR 1910.1030(h)(5)(i)
- OSHA 29 CFR 1910.334(a)(2)(ii)
- The Joint Commission NPSG.01.01.01; CLSI PRE02-Ed8 (inpatient identification)
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