SCFHS Phlebotomy Technician exam questions

The Phlebotomy Technician exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked Phlebotomy Technician practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Anatomy and Physiology

   A patient's tourniquet stayed on for about three minutes while the phlebotomist repeatedly asked him to pump his fist. Which pattern of results is most likely to be seen in the specimen?

   1. AUnchanged results, provided the sample reaches the laboratory in good time
   2. BRaised potassium, with higher total protein and cholesterol levels in the plasma
   3. CLowered sodium and chloride as the plasma becomes more dilute within minutes
   4. DLowered haematocrit and haemoglobin as fluid moves into the vessels
   Show answer and explanation

   Correct answer: B. Raised potassium, with higher total protein and cholesterol levels in the plasma

   Prolonged stasis and fist pumping push water out of the vessels and release potassium from muscle cells, so large molecules and cells are concentrated and potassium rises. Delay in transport is not the issue here.

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

2. Question 2 · Microbiology and Infection Control

   A phlebotomist is leaving a contact and droplet isolation room wearing gloves, goggles, a gown and a surgical mask. Which removal sequence is recommended?

   1. ARemove gloves, then goggles, then gown, then the mask, followed by hand hygiene
   2. BRemove the gown, then gloves, then goggles, then the mask, followed by hand hygiene
   3. CRemove goggles, then the mask, then gloves, then the gown, followed by hand hygiene
   4. DRemove the mask, then goggles, then gown, then gloves, followed by hand hygiene
   Show answer and explanation

   Correct answer: A. Remove gloves, then goggles, then gown, then the mask, followed by hand hygiene

   The most contaminated items, the gloves, come off first, then the eye protection and gown, and the mask is removed last outside the room so that the face is protected for as long as possible. Hand hygiene follows removal of all equipment.

   Reference: CDC Guideline for Isolation Precautions (2007)

3. Question 3 · Adult and Geriatric Blood Collection

   After chlorhexidine-alcohol skin preparation for blood cultures, the vein is difficult to feel. Which course of action preserves skin asepsis?

   1. APut a tourniquet directly over the cleaned site to bring the vein up
   2. BPull the skin taut using the fingers on the cleansed area
   3. CPalpate with a bare gloved finger because the antiseptic stays sterile for hours
   4. DRepeat the preparation after palpating, or palpate only with a sterile glove
   Show answer and explanation

   Correct answer: D. Repeat the preparation after palpating, or palpate only with a sterile glove

   Touching the site after cleansing reintroduces skin flora, which is the commonest cause of contaminated cultures, so the preparation must be repeated or a sterile glove used. The contamination rate affects interpretation of results and antibiotic decisions.

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

4. Question 4 · Adult and Geriatric Blood Collection

   A single light blue citrate tube is ordered on its own and a winged collection set is used. Why should a discard tube be filled first?

   1. ATo flush heparin out of the tubing before the specimen is taken
   2. BTo remove the skin plug that may contaminate the citrate specimen entirely
   3. CTo fill the tubing's air space so the citrate tube fills with the correct blood volume
   4. DTo deliver clot activator that will make the citrate specimen clot more quickly
   Show answer and explanation

   Correct answer: C. To fill the tubing's air space so the citrate tube fills with the correct blood volume

   Air in the tubing of a winged set would take the place of blood in the first tube, giving an underfilled citrate tube and a wrong blood to anticoagulant ratio. A discard tube without additive absorbs that air and is not needed for other tubes.

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

5. Question 5 · Paediatric Blood Collection

   A premature infant weighs 1.5 kg with an estimated blood volume of 90 mL/kg. Unit policy permits cumulative sampling up to 5% of blood volume over 48 hours, and 3.5 mL has already been drawn. How much more can be collected within the limit?

   1. AAbout 1.4 mL
   2. BAbout 10.0 mL
   3. CAbout 6.8 mL
   4. DAbout 3.3 mL
   Show answer and explanation

   Correct answer: D. About 3.3 mL

   Total blood volume is 135 mL, and 5% is about 6.75 mL, so subtracting the 3.5 mL already taken leaves about 3.3 mL. Cumulative limits protect small infants from iatrogenic anaemia.

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

6. Question 6 · Paediatric Blood Collection

   A heel stick is performed on a newborn to measure total bilirubin. Which handling step is essential for the specimen?

   1. AKeep the microtube uncapped in daylight to allow gas exchange before testing
   2. BWarm the specimen to 37 degrees Celsius until analysis
   3. CProtect the specimen from light with foil or an amber tube
   4. DPlace the specimen on ice immediately and keep it chilled
   Show answer and explanation

   Correct answer: C. Protect the specimen from light with foil or an amber tube

   Bilirubin is photolabile and breaks down on exposure to light, which gives falsely low results. Shielding the sample with foil or using an amber microtube preserves the true concentration.

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

7. Question 7 · Special Collections

   A cold agglutinin test has been requested. Which specimen handling is required?

   1. ACollect into a pre-warmed tube and keep it at 37 degrees Celsius until serum is separated
   2. BFreeze the whole blood immediately after collection so that the antibodies are preserved
   3. CPlace the tube on ice immediately after collection to stop further antibody binding
   4. DRefrigerate the specimen at 4 degrees Celsius for up to 24 hours before testing
   Show answer and explanation

   Correct answer: A. Collect into a pre-warmed tube and keep it at 37 degrees Celsius until serum is separated

   Cold agglutinins bind red cells at low temperature, so cooling the specimen would cause the antibodies to attach to the cells and be lost in the clot. Maintaining body temperature until separation keeps them in the serum for testing.

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

8. Question 8 · Donor Collection

   During a platelet apheresis procedure the donor reports tingling around the lips and fingers. What is the most likely cause and the correct response?

   1. AAir embolism; stop the procedure and lay the donor on the left side head down
   2. BCitrate-induced hypocalcaemia; slow the return rate and give oral calcium
   3. CA vasovagal reaction; elevate the legs and apply a cold compress to the neck
   4. DHaemolysis of red cells; stop the procedure and send blood for testing
   Show answer and explanation

   Correct answer: B. Citrate-induced hypocalcaemia; slow the return rate and give oral calcium

   Citrate is used to anticoagulate the extracorporeal circuit and binds ionised calcium, causing perioral and fingertip paraesthesia. Slowing the return and giving calcium reverses it, and it should be recognised before it progresses to muscle cramps.

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

9. Question 9 · Complications of Blood Collection

   Two days after a venipuncture, a patient telephones to say that his forearm still has numbness and tingling in the fingers. What is the most appropriate response?

   1. AAsk him to return so that the same site can be drawn again to check for nerve damage
   2. BAdvise a heat pack at home and no further follow-up of the symptoms is needed
   3. CDocument the report, notify the supervisor and refer him for clinical assessment
   4. DAdvise him that this always resolves by itself without any medical attention
   Show answer and explanation

   Correct answer: C. Document the report, notify the supervisor and refer him for clinical assessment

   Persistent paraesthesia suggests a nerve injury, which needs assessment and an incident report as injuries can be permanent if not managed. Reassurance alone delays care and puts the patient at risk.

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

10. Question 10 · Complications of Blood Collection

    Why must the tube holder and tube be positioned so that the tube is filled from the bottom up, below the level of the venipuncture site?

    1. ATo increase the vacuum pressure so that the tube fills more quickly and fully
    2. BTo prevent backflow of tube additive from the tube into the patient's vein during draw
    3. CTo reduce the exposure of the specimen to the surrounding room air and dust
    4. DTo prevent the sample from clotting in the holder before the next tube is attached
    Show answer and explanation

    Correct answer: B. To prevent backflow of tube additive from the tube into the patient's vein during draw

    Tubes contain additives, and if blood in the tube contacts the stopper and then flows back into the vein, additive can enter the circulation. Keeping the tube below the site, filling from the bottom and not letting the contents touch the stopper prevents this.

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

11. Question 11 · Ethics and Professional Practice

    After the patient has left, a phlebotomist realises that she labelled a tube with the wrong patient's label. What is the correct action?

    1. ASend the sample and ask the laboratory to confirm the identity later
    2. BPeel the label and apply the correct one while the patient waits
    3. CCorrect the label by hand and send the sample since the tube is full
    4. DDiscard the specimen, report the error and recollect a new sample
    Show answer and explanation

    Correct answer: D. Discard the specimen, report the error and recollect a new sample

    A mislabelled specimen cannot be trusted and could lead to a wrong diagnosis or an incompatible transfusion, so it is discarded and the patient recollected. Reporting the error supports learning and prevention.

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

12. Question 12 · Safety

    A phlebotomist who has not received the hepatitis B vaccine is exposed to blood after a needlestick from a source patient who is hepatitis B e-antigen positive. Compared with other bloodborne viruses, what is the approximate risk of infection?

    1. AHepatitis B carries the highest risk, about 6 to 30 percent in a non-immune worker
    2. BAll three viruses carry the same risk of around 1.8 percent after a needlestick
    3. CHepatitis C carries the highest risk, approximately 30 percent with no vaccine
    4. DHIV carries the highest risk, approximately 30 percent, and no vaccine is available
    Show answer and explanation

    Correct answer: A. Hepatitis B carries the highest risk, about 6 to 30 percent in a non-immune worker

    Hepatitis B is far more transmissible than hepatitis C, about 1.8 percent, or HIV, about 0.3 percent, which is why vaccination of all staff is mandatory. An e-antigen positive source is the highest-risk situation.

    Reference: CDC, Guidelines for Infection Control in Health-Care Personnel (1998), Bolyard et al.