Free SCFHS Phlebotomy Technician mock test

Phlebotomy Technician sample questions with answers

10 more original exam-style Phlebotomy Technician questions, worked in full. They are not real or recalled exam questions, and none of them is in the diagnostic above, so sit that first if you have not.

1. Question 1 · Anatomy and Physiology

   A STAT chemistry panel is to be run on plasma. Which anticoagulant prevents clotting by potentiating antithrombin and is found in a green top tube?

   1. ASodium citrate
   2. BSodium fluoride
   3. CPotassium EDTA
   4. DLithium heparin
   Show answer and explanation

   Correct answer: D. Lithium heparin

   Heparin enhances the activity of antithrombin, which inactivates thrombin and factor Xa, so the sample stays unclotted for plasma chemistry. EDTA and citrate work by binding calcium, and fluoride is a glycolysis inhibitor.

   Reference: Garza & McBride, Phlebotomy Handbook, 10th ed. (2018)

2. Question 2 · Microbiology and Infection Control

   A phlebotomist's hands are not visibly soiled after caring for a patient with Clostridioides difficile infection. What hand hygiene is most appropriate?

   1. ARinse with water alone since the hands are not visibly dirty
   2. BWash with soap and water since alcohol rubs do not reliably kill spores
   3. CUse an alcohol wipe on the gloves and keep the same gloves on for the next patient
   4. DUse an alcohol rub, which is fully effective against the spores
   Show answer and explanation

   Correct answer: B. Wash with soap and water since alcohol rubs do not reliably kill spores

   Spores of Clostridioides difficile resist alcohol, so mechanical removal by washing with soap and water is needed. Alcohol rubs are otherwise preferred for routine hand hygiene.

   Reference: WHO Guidelines on Hand Hygiene in Health Care (2009)

3. Question 3 · Adult and Geriatric Blood Collection

   An elderly patient has small, fragile veins and thin skin that tears easily. Which collection approach is most suitable?

   1. AA 16-gauge needle with 10 mL tubes to reduce the time taken to fill all tubes
   2. BA 21-gauge needle with vigorous fist pumping to raise the veins before the draw
   3. CA 23-gauge winged set with low-volume tubes and a loose tourniquet
   4. DAn 18-gauge straight needle with a tightly applied tourniquet
   Show answer and explanation

   Correct answer: C. A 23-gauge winged set with low-volume tubes and a loose tourniquet

   Small veins are best accessed with a narrow, flexible winged set and smaller tubes that create less vacuum, and a tourniquet that is loose or placed over a sleeve avoids skin tears. A large needle or heavy pressure would damage the vein and skin.

   Reference: WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy (2010)

4. Question 4 · Adult and Geriatric Blood Collection

   A patient has a fresh left-sided mastectomy with lymph node removal, and an infusion is running in the right forearm. What is the most appropriate approach?

   1. AGet clinician approval, then use a vein below the right IV after pausing the infusion
   2. BDraw from the left arm on the mastectomy side since it has no infusion running
   3. CDraw above the right IV site while the infusion continues to run as normal
   4. DDraw from the right IV tubing to avoid any further needle puncture of the patient
   Show answer and explanation

   Correct answer: A. Get clinician approval, then use a vein below the right IV after pausing the infusion

   The side of a mastectomy with node removal is avoided because of lymphoedema risk, so alternatives are limited and clinician approval is needed. If the infusion arm is used, the infusion is stopped for at least two minutes and the sample is taken below the infusion site.

   Reference: CLSI GP41, Collection of Diagnostic Venous Blood Specimens, 7th ed. (2017)

5. Question 5 · Paediatric Blood Collection

   For which of the following children is a heel puncture no longer recommended as the capillary site?

   1. AA 6-month-old infant who is lying on the examination bed and is calm and alert
   2. BA 14-month-old who walks, because the heel is calloused from weight bearing
   3. CA 2-day-old term newborn who is sleeping and is quite unwell with a fever
   4. DA 3-week-old infant who weighs 3.5 kg and is feeding well at the breast
   Show answer and explanation

   Correct answer: B. A 14-month-old who walks, because the heel is calloused from weight bearing

   Walking thickens and calluses the heel and increases the risk of bone injury, so heel puncture is limited to infants who are not yet walking. A finger or a vein is used in older children.

   Reference: CLSI GP42, Collection of Capillary Blood Specimens, 7th ed. (2020)

6. Question 6 · Paediatric Blood Collection

   Which finger and site are recommended for a capillary puncture in an adult?

   1. AThe pad of the thumb where blood supply is richest, on any side
   2. BThe centre of the index fingertip, with the puncture along the fingerprint lines
   3. CThe lateral pad of the middle or ring finger, cut across the fingerprint lines
   4. DThe tip of the little finger, where the skin is thinnest and least painful
   Show answer and explanation

   Correct answer: C. The lateral pad of the middle or ring finger, cut across the fingerprint lines

   The middle and ring fingers are preferred, and the cut is made across the fingerprint whorls so that blood forms a drop, whereas a puncture parallel to the lines lets blood run along the grooves. The thumb and index finger are calloused, and the little finger has too little tissue over bone.

   Reference: CLSI GP42, Collection of Capillary Blood Specimens, 7th ed. (2020)

7. Question 7 · Special Collections

   Blood cultures are requested for an adult with suspected sepsis. What volume per set, divided between the two bottles, is recommended?

   1. AThirty mL placed in a single aerobic bottle for the set
   2. BOne to two mL per bottle, giving about 3 mL per set
   3. CFive mL in total for the set, divided between the bottles
   4. DEight to ten mL per bottle, giving about 20 mL per set
   Show answer and explanation

   Correct answer: D. Eight to ten mL per bottle, giving about 20 mL per set

   Detection of bacteraemia depends on volume, and in adults each additional millilitre of blood increases the yield, so about 20 mL per set is recommended. The volume must be divided between aerobic and anaerobic bottles and not exceed the bottle fill line.

   Reference: CLSI M47, Principles and Procedures for Blood Cultures, 1st ed. (2007)

8. Question 8 · Donor Collection

   A male whole blood donor with haemoglobin 14.0 g/dL presents five weeks after his last donation. The centre's procedure sets a minimum interval of eight weeks. What is the correct decision?

   1. ADefer him until eight weeks have passed since his last donation
   2. BAccept him because the haemoglobin level is adequate for donating
   3. CAccept him and halve the volume collected to compensate for the short interval
   4. DAccept him if he agrees to take iron supplements daily afterwards
   Show answer and explanation

   Correct answer: A. Defer him until eight weeks have passed since his last donation

   The minimum interval allows iron stores and blood volume to recover, regardless of a currently normal haemoglobin. Donors are asked to return after the full interval has elapsed.

   Reference: AABB Standards for Blood Banks and Transfusion Services, 33rd ed. (2022)

9. Question 9 · Complications of Blood Collection

   A patient with a known latex sensitivity develops hives and wheezing soon after the tourniquet is applied. What is the best immediate response?

   1. AApply a fresh latex tourniquet over the original and finish the blood draw
   2. BAsk the patient to wait in the waiting area and observe the skin for a while
   3. CContinue with the draw because the symptoms will pass quickly
   4. DStop, remove latex items, call emergency help and monitor the airway
   Show answer and explanation

   Correct answer: D. Stop, remove latex items, call emergency help and monitor the airway

   Hives with wheeze indicate a systemic allergic reaction that can progress to anaphylaxis, so the allergen is removed and emergency help summoned. Latex-free equipment should be used for patients with known sensitivity.

   Reference: WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy (2010)

10. Question 10 · Safety

    How should a blood specimen be packaged for transport from the ward to the laboratory?

    1. AIn a paper envelope, with the request form wrapped around the tube for safety
    2. BIn a sealed biohazard bag, with the request in the separate outer pocket
    3. CIn an open rack, with the request form tucked in beside the tubes
    4. DIn a coat pocket for speed, with the request form folded inside the tube holder
    Show answer and explanation

    Correct answer: B. In a sealed biohazard bag, with the request in the separate outer pocket

    Leak-proof bagging contains spills and protects handlers, and keeping the request separate prevents contamination of the paperwork. Specimens should never be carried loose or in personal clothing.

    Reference: WHO Guidance on Regulations for the Transport of Infectious Substances (2019-2020)