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NCCT Practice Test Exam 2026 ||
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Which of the following actions should the phlebotomist take to decrease the potential for hemolysis of blood specimen in an EDTA tube? A. Store the tube in the refrigerator after the specimen has been collected B. Use a 25 gauge needle or smaller to collect the specimen C. Allow the tube to stand for 20 minutes prior to processing D. Gently invert the tube after collecting the specimen correct answers Gently invert the tube after collecting the specimen Since an EDTA tube contains anticoagulant, it is important to immediately mix the blood as soon as it is collected to ensure that it doesn't clot. The phlebotomist should gently invert the tube after collecting the specimen to maintain specimen integrity and prevent rupture of RBC's in the sample. Small red spots appear near the tourniquet on a patient's arm. This is MOST likely an indication of A. a collapsed vein. B. a hematoma. C. petechiae. D. edema. correct answers Petechiae Small red spots near the tourniquet on a patient's arm are most likely indicative of petechiae. Petechiae are small, red, non-raised spots that appear in response to pressure from the tourniquet. Which of the following is outside the scope of practice for a phlebotomist? A. Verifying equipment function on point of care testing using a control. B. Prioritizing collections based on order requests.
C. Recording quality control results on a log sheet. D. Performing CLIA high complexity tests. correct answers Performing CLIA high complexity tests CLIA refers to the Clinical Laboratory Improvement Amendment, which specifies personnel requirements for performing laboratory testing based upon their complexity. Moderate and high complexity testing are outside the scope of practice for a phlebotomist. Medical assistants may perform CLIA-waived testing, such as Point of Care Testing, with proper training. If a phlebotomist has questions about disposing of outdated hazardous chemicals, where should she look to find this information? A. HIPAA B. MSDS C. CLIA D. NIOSH correct answers MSDS A Material Safety Data Sheet (MSDS) is a hazardous chemical reference. It provides healthcare workers with procedures for working with substances safety to ensure regulatory compliance. When inserting a needle during venipuncture, the bevel should be in which of the following positions in relation to the vein? A. Up B. Down C. Left D. Right correct answers Up Which of the following is an example of a pre-analytical error made at the time of collection? A. Delay in transporting B. Failing to mix tubes C. Incomplete requisition D. Waiting to centrifuge correct answers Failing to mix tubes
A. Check controls on urinalysis reagent strips daily. B. Ensure supplies in venipuncture trays are no more than one month beyond the expiration date. C. Ensure reusable supplies in venipuncture trays are recycled. D. Check glucometer controls monthly. correct answers Check controls on urinalysis reagent strips daily. Proper Quality Control ensures accuracy and reliability of test results while detecting and eliminating errors. It is an important component of patient care to make sure results are accurate, therefore it is important to check controls on urinalysis dipsticks daily. A patient on coumadin therapy is at the lab for a weekly coagulation test. Which of the following tubes should the phlebotomist collect for this test? A. Red top B. Lavender top C. Light blue top D. Green top correct answers Light Blue Top Sodium citrate (light blue top tube) is the anticoagulant of choice for coagulation studies such as PT/INR (Protime/International Normalization Ratio) because it does not bind to calcium or inactivate heparin, which may be required to be present in such testing While performing a venipuncture, the phlebotomist removes the filled tubes, but forgets to remove the tourniquet prior to needle withdrawal. Which of the following is the MOST likely result? A. Syncope B. Hemoconcentrated specimen C. Hematoma D. Hemolyzed specimen correct answers Hematoma A hematoma is a large painful bruise at the puncture site, caused or created by blood seeping into the surrounding tissues, one of the causes is the delay in tourniquet release
and pulling the vacuum tube out. Since the tourniquet is causing the veins to bulge this will prevent quick clotting, and cause bruising. The phlebotomist is educating the patient on fasting diet requirements prior to a glucose tolerance test. Which of the following is the minimum time frame the patient must remain fasting before the start of the test? A.13-24 hours B. 8-12 hours C. 1-2 hours D. 3-4 hours correct answers 8-12 hours To ensure accuracy of the blood test results. Gum chewing, eating mints, and/or smoking are not allowed. Sips of water may be permitted depending on provider NPO policy. The phlebotomist has an order to collect a complete blood count with differential, partial thromboplastin time, basic metabolic panel, and blood cultures. What is the collection tubes in the correct order of draw. A. Red B. Lavender C. Blood culture bottles D. Light blue correct answers Blood culture bottles, Light blue, Red, Lavender What does the color of an evacuated collection tube represent? A. A visual identifier for tests expected to be above or below normal range B. The minimum volume of blood to be obtained C. The personal protective equipment required for collection D. The type or absence of an additive correct answers The type or absence of an additive
D. Hemangioma correct answers Hemoconcentration In the middle of a blood draw the patient experiences a seizure. Which of the following should the phlebotomist do after removing the tourniquet and withdrawing the needle? (Select the two (2) correct answers.) A. Call for help. B. Place gauze in the patient's mouth. C. Protect the patient's head and lower her to the floor. D. Place the patient in Trendelenburg position. E. Observe the patient in the chair for at least 45 minutes after the seizure. correct answers Call for help Protect the patient's head and lower her to the floor. A phlebotomist working in a hospital is collecting blood from a patient with very small, difficult veins. Three tubes of blood need to be collected. The blue and green tubes fill easily and completely, but the lavender tube fills incompletely. Changing the lavender tube using the same draw also results in an incomplete specimen. Which of the following should the phlebotomist do NEXT? A. Re-position the needle and recollect the lavender tube. B. Re-draw the patient using a different site and obtain all three tubes. C. Submit the samples as drawn. D. Resubmit the draw order for the next round of draws correct answers Re-position the needle and recollect the lavender tube. A phlebotomist puts evacuated tubes filled with blood in plastic transport bags and places them in the physician office lock box for the reference lab courier who will pick them up in 1-2 hours. The lock box is outside and the temperatures are below freezing. How will freezing affect the test results? A. Elevated hematocrit B. Decreased red blood cell count C. Elevated hemoglobin
D. Decreased calcium correct answers Decreased red blood cell count Which of the following is the correct order of PPE removal prior to leaving the exam room of a patient who is in contact-droplet isolation? A. Gloves, gown, mask B. Gown, gloves, mask C. Gown, mask, gloves D. Gloves, mask, gown correct answers Gown, gloves, mask For which of the following patients is the use of an adhesive bandage contraindicated? A. Adult with hemophilia B. Immunocompromised child C. Adolescent with sickle cell anemia D. Newborn with hyperbilirubinemia correct answers Newborn with hyperbilirubinemia The person collecting a blood sample from a newborn with hyperbilirubinemia would not use an adhesive bandage post-stick. Bleeding would be stopped by direct pressure and no bandage would be utilized. It is not recommended to use a bandage on children under two years of age because it could introduce a choking hazard if the child works the bandage loose. When performing venipuncture on a patient with a left mastectomy, which of the following sites should the phlebotomist use? A. Back of left hand B. Right antecubital fossa C. Right saphenous vein D. Left basilic vein correct answers Right antecubital fossa The phlebotomist has a requisition for chemistry and coagulation testing. Which of the following is the correct tube selection and order of draw?
D. Uncap the evacuated tubes, place them into a tube rack and transfer blood from the syringe using a syringe transfer device. correct answers Remove the hypodermic needle from the syringe after activating the safety device and transfer the blood into capped evacuated tubes using a syringe transfer device The patient on hemodialysis with a left AV shunt has undergone a right sided mastectomy and has an order for a STAT glucose. After consulting with the physician the phlebotomist is told to perform a capillary draw. Which of the following sites should the phlebotomist use? A. Right middle finger B. Left ring finger C. Left thumb D. Right little finger correct answers Left ring finger While performing a capillary stick on a six-month-old infant's heel, the lancet should be no longer than A. 2.0 mm. B. 2.0 cm. C. 3.0 cm. D. 3.0 mm. correct answers 2.0 mm. The phlebotomist has collected an ammonia level. Which of the following should be done regarding transport of the specimen? A. Maintain the specimen at room temperature. B. Wrap the specimen in a heel warmer to slow the metabolic process. C. Wrap the specimen in foil to protect from light. D. Immerse the specimen in an ice and water slurry correct answers Immerse the specimen in an ice and water slurry Ammonia level must be transported immersed in a slurry of ice and water in order to slow down cellular metabolism and reduce evaporation.
Which of the following organizations makes on-site visits to inspect phlebotomy laboratories? A. ASCLS B. DEA C. CLIA D. FDA correct answers CLIA Venipuncture should be avoided on an arm with A. excessive hair. B. muscular hypertrophy. C. an elbow splint. D. alopecia. correct answers an elbow splint A patient with a cast/splint in place may have ongoing extremity swelling during the healing process. Use as a venipuncture site should be avoided. The phlebotomist arrives at an inpatient room to collect a blood sample. There is an isolation cart located outside the room. The phlebotomist washes her hands and puts on the following personal protective equipment: gown, gloves, and mask. Which of the following types of precautions are being used for this patient? A. Contact Droplet Airborne B. Contact Droplet C. Standard Airborne D. Contact Airborne correct answers Contact Droplet A patient with an order for a blood draw presents with burns covering both arms. Which of the following is the phlebotomist's BEST option for collecting the largest amount of blood for this patient? A. Microcollection container B. Capillary tube C. Filter paper (PKU) card D. Evacuated tube correct answers Microcollection container
A. Explain the interpretation behind the POC tests, but let the patient read the directions with the higher level tests. B. Explain the interpretation behind the POC care tests, but refer the patient to the physician for the higher complexity tests. C. Refer the patient to the physician for interpretation of waived and higher-level results. D. Hand the patient pre-printed test explanations downloaded from the CDC web site. correct answers Refer the patient to the physician for interpretation of waived and higher-level results. When a phlebotomist enters a patient's room to collect a STAT blood sample, a sign above the bed states that all collections should be from the patient's central port. Which of the following should the phlebotomist do NEXT? A. Proceed with sample collection from the central port and alert the nurse when finished. B. Communicate the test order to the nursing staff and wait for one of them to collect the sample. C. Identify the patient and ask for confirmation that the sign is accurate before proceeding with the collection. D. Exit the patient's room and proceed directly to the next patient on the collection list. correct answers Communicate the test order to the nursing staff and wait for one of them to collect the sample. Which of the following is a site preparation solution required for collecting blood cultures and blood alcohol levels? A. Povidone-iodine B. Soap and water C. Hydrogen peroxide D. Isopropyl alcohol correct answers Povidone-iodine The phlebotomist is drawing blood on an 88-year-old patient that has multiple skin tears. Which of the following should be used to secure the 2 x 2 gauze sponge? A. Paper tape
B. Adhesive tape C. Band aid D. Coban correct answers Coban A phlebotomist collects a cryofibrinogen specimen, places the specimen in a biohazard specimen bag, then onto slurry of ice and water and transports it to the laboratory in a timely manner. In this case the phlebotomist A. performed proper specimen handling. B. should have protected the specimen from light. C. should have kept the specimen at 37˚C. D. should have aliquoted the specimen before transport. correct answers should have kept the specimen at 37˚C. Many types of specimens are required to be kept at certain temperatures for accurate test results to be obtained by the laboratory. Cryofibrinogen, cryoglobulin and cold agglutinins must be kept at 37o C (body temperature). Tests requiring protection from light include: bilirubin, carotene, porphyrins and vitamins A, B2, and C. Specimens that require chilling on an ice slurry are ammonia, lactic acid, pH & blood gases among others. Which of the following actions should the phlebotomist take to make a vein more prominent when attempting to select a venipuncture site? A. Firmly tap the arm several times and palpate with a non-gloved finger. B. Apply a warm compress to the area for 5 minutes. C. Leave the tourniquet in place and ask the patient to dangle the arm for one minute. D. Apply firm pressure to the arm from the shoulder to the elbow. correct answers Apply a warm compress to the area for 5 minutes. Warm moist heat promotes circulation and vasodilation and will help make the vein more visible A centrifuge functions in which of the following ways? A. Slowly warms a refrigerated blood specimen to room temp B. Magnifies cellular blood components
A. HIPAA
B. CLIA
C. DEA
D. OSHA correct answers CLIA What is the MOST common site to draw an arterial blood collection? A. Brachial artery B. Hepatic artery C. Peroneal artery D. Radial artery correct answers Radial artery How should the phlebotomist prepare the skin for a venipuncture of the median cubital vein? A. Use back-and-forth friction, applied horizontally or vertically. B. Apply concentric circular friction, working from the outside inward. C. Wipe the area lightly from top to bottom in a spiral motion. D. Wipe the area lightly from bottom to top correct answers Use back-and-forth friction, applied horizontally or vertically Which of the following actions by the phlebotomist is the FIRST line of defense in preventing the spread of microorganisms? A. Wear non-sterile gloves when performing venipuncture B. Perform regular hand hygiene C. Wear sterile gloves when changing a dressing D. Use aseptic technique when drawing up a medication correct answers Perform regular hand hygiene Which of the following would be considered a hospital acquired infection? A. A 72-year-old patient in the ER with flu-like symptoms. B. An 8-year-old patient admitted with chicken pox. C. A patient who contracts a MRSA infection from a venipuncture. D. A healthcare worker that develops Hepatitis C. correct answers A patient who contracts a MRSA infection from a venipuncture.
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? A. Put a cartoon character bandage on the site. B. Bandage with a pressure dressing. C. Tape a sterile gauze pad over the site. D. Do not bandage. correct answers Do not bandage Which of the following is a requirement for a healthcare facility to be in compliance with OSHA? A. Payment of annual dues B. Current certificate of compliance on file C. Annual employee safety training D. Annual inspections conducted by OSHA correct answers Annual employee safety training The physician has ordered a prothrombin time (PT) and complete blood count (CBC) for an adult patient with a diagnosis of thrombophlebitis. The phlebotomist should collect the evacuated tubes in which of the following orders? A. Lavender, light blue B. Light blue, red C. Light blue, lavender D. Red, light blue correct answers Light blue, lavender When disposing of hazardous materials, the phlebotomist must adhere to the guidelines and standards set forth by A. OSHA. B. CLIA. C. FDA. D. CMS. correct answers OSHA Which of the following techniques should the phlebotomist use when performing a venipuncture on a geriatric patient with loose skin?
The phlebotomist is asked to draw blood from a patient with an IV in the right arm whose left arm is inaccessible. The phlebotomist may draw without a physician's approval from the A. foot. B. IV line. C. right arm proximal to the IV site. D. right arm distal to the IV site. correct answers right arm distal to the IV site The proper technique to anchor a vein is to use the non-dominant thumb A. to pull the skin toward the wrist. B. and forefinger to stretch the skin above and below the site. C. to apply direct downward pressure. D. and forefinger to apply direct downward pressure above and below the site. correct answers to pull the skin toward the wrist. Which of the following QC measures are within the phlebotomist's scope of practice? [Select 3] A. Checking the expiration dates of venipuncture supplies B. Performing calibration on the chemistry analyzer C. Monitoring temperatures of specimen refrigerators D. Daily maintenance on the laboratory hematology instruments E. Perform daily glucose meter control checks correct answers Checking the expiration dates of venipuncture supplies, Monitoring temperatures of specimen refrigerators, Perform daily glucose meter control checks A tourniquet was left on the arm for an extensive period of time before the performance of a venipuncture. Which of the following is MOST likely to occur? A. The patient will have excessive bleeding. B. The patient will develop a hematoma. C. The blood specimen will be hemolyzed. D. The blood specimen will be hemoconcentrated. correct answers The blood specimen will be hemoconcentrated
Hemoconcentration is decrease in the volume of plasma in relation to the number of red blood cells. Prolonged tourniquet use impedes circulation and will cause this to happen, but will likely not cause hemolysis or a hematoma Which of the following is the CLSI recommended micro-collection order of draw for a BMP, CBC and bilirubin? A. Lavender, green, red B. Green, lavender, red C. Lavender, red, green D. Red, green, lavender correct answers Lavender, green, red The recommended Order of Draw for capillary blood collection is different from blood specimens drawn by venipuncture. CLSI recommends the following order of draw for skin puncture: Blood gases, EDTA tubes, Other additive tubes, then Serum tubes. Which task should a phlebotomist complete prior to daily use of a POCT instrument? A. Run the test patient sample. B. Perform QC on the instrument. C. Ensure that QC was performed within the last month. D. Calibrate the instrument. correct answers Perform QC on the instrument. When performing a venipuncture, sudden swelling is observed at the insertion site. Which of the following actions should the phlebotomist take? A. Continue obtaining the blood sample. This is a localized reaction to the venipuncture. B. Release the tourniquet, remove the needle, and immediately apply pressure at the site. C. Apply firm pressure above the area of swelling to direct the blood flow into the collection device. D. Leave the tourniquet in place, immediately remove the needle, and apply pressure at the site. correct answers Release the tourniquet, remove the needle, and immediately apply pressure at the site.
