NHA Phlebotomy-Technician Practice Exam Questions & Answers

The phlebotomist should immediately flush the eye with water at an eyewash station. Blood exposure to mucous membranes is a bloodborne pathogen exposure incident and requires immediate decontamination before administrative steps. Wiping the eye with gauze is inadequate and can irritate tissue or fail to remove infectious material. Continuing patient collections delays treatment and increases occupational risk. Applying antibiotic ointment is outside the phlebotomist's role and does not replace proper exposure response. After flushing, the phlebotomist must report the incident according to facility policy, complete required documentation, and obtain occupational health follow-up. This may include source-patient evaluation, baseline testing, and post-exposure prophylaxis assessment when indicated. The correct professional sequence is decontaminate first, report immediately, document accurately, and follow the exposure-control plan. This question tests standard precautions, exposure control, OSHA-related safety obligations, and emergency response in the phlebotomy environment. Reference topics: Safety and Compliance; bloodborne pathogen exposure; mucous membrane exposure; eyewash use; incident reporting.

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.

Erythrocytes are primarily responsible for oxygen transport. They contain hemoglobin, the iron-containing protein that binds oxygen in the lungs and releases it to tissues. Platelets are involved in hemostasis and clot formation, not oxygen transport. Leukocytes are white blood cells that support immune defense. Plasma proteins perform functions such as maintaining oncotic pressure, transporting substances, and supporting clotting through proteins such as fibrinogen, but they are not the primary oxygen carriers. This foundational knowledge matters because phlebotomy technicians work with specimens used to evaluate red blood cell count, hemoglobin, hematocrit, indices, anemia, blood loss, and hemolysis. If a specimen is hemolyzed, red blood cells rupture and release intracellular contents, which can alter laboratory values. Understanding blood components helps the technician connect collection technique to specimen integrity. For example, rough handling, excessive suction, improper needle size, or vigorous shaking can damage erythrocytes and compromise results. Reference topics: Phlebotomy Fundamentals; blood components; erythrocytes; hemoglobin; CBC testing.

The phlebotomist should ask, ''When was the last time you had anything to eat or drink other than water?'' This question directly verifies fasting status and avoids a vague yes/no answer. Patients may misunderstand fasting and think coffee, juice, gum, candy, or a small snack does not count. Asking about medication is important for some tests, but it does not verify fasting. Asking why the provider ordered the test is outside the phlebotomist's interpretive role and may lead to unauthorized clinical discussion. Asking whether the patient has had the test before does not confirm current preparation. Accurate fasting verification is part of patient preparation and preanalytical quality control. If the patient has not fasted as required, the phlebotomist should follow facility policy, notify appropriate personnel, document noncompliance if collection proceeds, or reschedule if instructed. Poor preparation can produce misleading chemistry results and unnecessary repeat testing. Reference topics: Patient Preparation; fasting verification; patient interview; basal-state requirements; preanalytical variables.

The phlebotomist should notify the nurse or provider according to facility policy. A competent adult patient has the right to refuse a blood draw, even when the test is ordered. Proceeding against the patient's refusal is unethical and can constitute battery. Asking a family member to pressure the patient is inappropriate because consent must come from the patient or legally authorized representative when applicable, not from coercion. Using a smaller needle does not address refusal unless the patient specifically refused because of needle size and then gives consent after discussion. The phlebotomist should remain professional, clarify the patient's concern within scope, avoid arguing, document or report the refusal as required, and allow authorized clinical personnel to follow up. This question tests patient rights, consent, communication, and scope of practice. Phlebotomy is invasive, so consent is not optional. The technician's authority ends where patient refusal begins unless a specific emergency or legal policy applies through authorized medical personnel. Reference topics: Patient Preparation; patient refusal; consent; patient rights; communication; documentation.

The specimen must be redrawn in an unexpired tube. Expired additive tubes cannot be trusted because the vacuum, sterility, additive concentration, stopper integrity, and chemical performance may be compromised. Once blood has been collected into an expired additive tube, the specimen is already affected by that collection environment; transferring it into another tube does not correct the original exposure and can introduce additional hemolysis, contamination, clotting, or additive-ratio errors. Placing the specimen on ice does not reverse an expired additive problem. Submitting the specimen because the tube is ''within 30 days'' of expiration is unsafe; expired means expired, and laboratory acceptance criteria are based on valid collection supplies. This is a preventable preanalytical error, and the phlebotomist should also remove expired supplies from use to prevent recurrence. Tube expiration checks must occur before collection, not after the draw. Reference topics: Processing Specimens; preanalytical error; expired supplies; specimen rejection; tube quality control; recollection procedures.