Free Practice Questions for NHA Phlebotomy-Technician Exam

Answer : A

The laboratory should reject an unlabeled specimen. A specimen without patient identification cannot be reliably linked to the correct patient, even if a requisition is nearby or a provider verbally confirms the order. Labeling a tube later from the requisition is unsafe because it breaks the chain between patient, collection event, and specimen. Testing based only on an order number does not meet safe identification practice. Verbal confirmation after the fact cannot correct an unlabeled specimen because the tube's identity was not secured at the bedside or collection site. Proper labeling should occur immediately after collection in the presence of the patient, using required identifiers such as full name, date of birth, medical record number, date/time of collection, and collector identity according to facility policy. Mislabeling and unlabeled specimens are serious preanalytical errors that can cause wrong diagnosis, wrong treatment, transfusion risk, and patient harm. Reference topics: Processing Specimens; specimen labeling; patient identification; rejection criteria; preanalytical error.

Answer : A

The vein is anchored by placing the thumb of the free hand below the intended puncture site and gently pulling the skin taut. This stabilizes the vein, reduces rolling, creates a firmer puncture surface, and supports accurate needle entry. Anchoring above the site is unsafe because it places the phlebotomist's hand in the direction of needle travel and increases needlestick risk. Using two fingers instead of the thumb provides less controlled traction and may interfere with the venipuncture angle or contaminate the prepared site. The phlebotomist should avoid touching the cleansed puncture site after antisepsis unless the site is re-cleansed. Proper anchoring is especially important for superficial or mobile veins because failure to stabilize the vein can cause missed access, hematoma formation, probing, patient discomfort, or specimen collection failure. The NHA CPT outline identifies anchoring the vein below the venipuncture site and knowledge of anchoring techniques as routine venipuncture competencies. Reference topics: Routine Blood Collections; site selection; anchoring below venipuncture site; venous anatomy and safe insertion technique.

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Answer : A

The best site for phenylketonuria, or PKU, collection on an infant is the medial or lateral plantar surface of the heel. PKU screening is a newborn metabolic screening test commonly collected by heel stick onto filter paper. The medial and lateral heel areas are selected because they provide adequate capillary blood flow while reducing the risk of puncturing bone. The central area of the heel is unsafe because the calcaneus may be closer to the puncture site, increasing the risk of bone injury or osteomyelitis. Fingertip puncture is inappropriate for infants because the tissue is small, bone is close to the surface, and the site does not provide the recommended specimen collection area for newborn screening. Proper PKU collection also requires warming the heel when indicated, allowing blood to flow freely, filling filter-paper circles completely from one side, avoiding layering, and allowing the specimen to dry properly before transport. NHA CPT special collection content includes collecting blood for metabolic syndromes such as PKU, filter-paper collection techniques, pediatric considerations, and minimum/maximum volume requirements. Reference topics: Special Collections; PKU collection; infant heel puncture; filter-paper specimen collection.

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Answer : C

An anticoagulant is the medication type most directly associated with an INR draw. INR, or international normalized ratio, is used to evaluate clotting time and is especially important for monitoring patients who take warfarin or other anticoagulant therapy. These medications reduce the blood's ability to clot, so laboratory monitoring helps determine whether the patient is within the therapeutic range or at risk for bleeding or clotting complications. Anti-inflammatory medications may affect bleeding risk in some situations, but they are not the primary indication for an INR draw. Antihistamines are used for allergic symptoms, and antiemetics are used for nausea or vomiting; neither is routinely monitored by INR. From a phlebotomy standpoint, anticoagulant therapy also alerts the technician to apply pressure longer after venipuncture and observe for prolonged bleeding. Reference topics: Special Collections; coagulation testing; point-of-care INR; medication-related collection considerations; hemostasis. The NHA CPT test plan includes special collections, waived testing, and coagulation/hemostasis-related competencies.

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Answer : A

Leukopenia means a decreased number of white blood cells. ''Leuko-'' refers to white blood cells, and ''-penia'' means deficiency or decrease. Leukocytosis means an increased white blood cell count and is often associated with infection, inflammation, stress response, or hematologic disorders. Thrombocytopenia means a decreased platelet count, which can increase bleeding risk after venipuncture. Erythrocytosis means an increased red blood cell count. This terminology matters to phlebotomy because laboratory orders and patient conditions often use hematologic language. The phlebotomist does not diagnose these conditions, but understanding terms helps the technician anticipate safety concerns and specimen requirements. For example, thrombocytopenia may require longer pressure after collection, while leukopenia may be associated with immunocompromised status and strict infection-control awareness. A CBC is the common test used to evaluate red cells, white cells, hemoglobin, hematocrit, and platelets. Reference topics: Phlebotomy Fundamentals; medical terminology; hematology; CBC components; blood cell disorders.