Phlebotomy Technician Prometric exam questions with answers

1. Question 1Anatomy and Physiologyeasy

   A student asks why blood leaving an artery spurts, whereas venous blood flows steadily. Which structural feature of arteries best explains this?

   1. AA thick, elastic and muscular middle layer built for high pressure
   2. BOne-way valves along the lumen that keep the flow pulsatile
   3. CAn inner lining without endothelium that speeds up blood flow
   4. DA wide, thin-walled lumen that buffers each heartbeat so flow is smooth and constant
   Show answer and explanation▾

   Answer: A. A thick, elastic and muscular middle layer built for high pressure

   Arteries have a thick tunica media rich in elastic fibres and smooth muscle, which tolerates and transmits the high pressure generated by ventricular contraction. Valves are a feature of veins, which have thinner walls and carry blood at low pressure.

2. Question 2Microbiology and Infection Controleasy

   A phlebotomist has just removed gloves after completing a venipuncture and labelling the tubes. What hand hygiene is required at this point?

   1. AA dry paper towel wipe followed by a fresh pair of gloves
   2. BHand hygiene with an alcohol-based rub or soap and water
   3. CNone, because the gloves already acted as a complete barrier
   4. DHand washing only if blood is visible on the gloves afterwards
   Show answer and explanation▾

   Answer: B. Hand hygiene with an alcohol-based rub or soap and water

   Gloves can have undetectable defects and hands become contaminated during removal, so hand hygiene is required after glove removal every time. It is part of the WHO moments for hand hygiene and is not conditional on visible soiling.

3. Question 3Adult and Geriatric Blood Collectioneasy

   A phlebotomist applies a tourniquet before searching for a vein in an adult. What is the longest the tourniquet should stay on before it is released?

   1. AUp to three minutes while the veins are located
   2. BUp to five minutes when the veins are small
   3. CNo longer than one minute, to avoid haemoconcentration
   4. DUp to ten minutes if the patient is dehydrated
   Show answer and explanation▾

   Answer: C. No longer than one minute, to avoid haemoconcentration

   Prolonged tourniquet application causes venous stasis and haemoconcentration, which alters analytes such as potassium, proteins and calcium. It should be released within one minute, and if more time is needed it should be released for two minutes and then reapplied.

4. Question 4Adult and Geriatric Blood Collectionmedium

   A patient has a saline infusion running in the right forearm, and the left arm has intact accessible veins with no restrictions. Which collection site is most appropriate?

   1. AA vein on the back of the right hand beside the infusion line
   2. BA vein above the infusion site in the right arm with the drip running
   3. CA vein below the infusion site in the right arm without stopping the drip
   4. DA suitable vein of the left arm, the arm without the infusion
   Show answer and explanation▾

   Answer: D. A suitable vein of the left arm, the arm without the infusion

   The preferred approach is to use the opposite arm, since fluid from an infusion contaminates and dilutes the specimen and gives misleading results. Drawing from an infusion arm is only considered when no alternative exists and the infusion has been stopped.

5. Question 5Adult and Geriatric Blood Collectionmedium

   A 78-year-old man taking warfarin has just had a venipuncture at the antecubital fossa. After withdrawing the needle, what is the most appropriate step?

   1. AHold firm pressure for at least five minutes and check the site
   2. BPlace a bandage immediately and let him leave after thirty seconds
   3. CApply pressure for thirty seconds and then cover with a pressure bandage
   4. DAsk him to bend the arm tightly over a gauze pad and release it after one minute
   Show answer and explanation▾

   Answer: A. Hold firm pressure for at least five minutes and check the site

   Anticoagulated patients take longer to achieve haemostasis, so pressure should be held until bleeding stops, usually well beyond the standard time. Bending the arm is discouraged because it can cause a haematoma to form.

6. Question 6Adult and Geriatric Blood Collectionhard

   Two blood culture sets are ordered for a febrile adult and a winged (butterfly) collection set with tubing is used to fill an aerobic and an anaerobic bottle. Which statement is correct?

   1. AInoculate the anaerobic bottle first because tubing air contains oxygen needed by anaerobes
   2. BFill a lavender tube first and then both culture bottles to save time on the draw
   3. CInoculate the aerobic bottle first so air in the tubing does not enter the anaerobic bottle
   4. DCollect both sets through the same venipuncture to reduce contamination of the skin
   Show answer and explanation▾

   Answer: C. Inoculate the aerobic bottle first so air in the tubing does not enter the anaerobic bottle

   When a winged set is used, the air in the tubing enters the first bottle filled, so the aerobic bottle is filled first to avoid introducing oxygen into the anaerobic bottle. Each set should come from a separate venipuncture site to help distinguish true bacteraemia from contamination.

7. Question 7Paediatric Blood Collectioneasy

   A 3-day-old full-term infant requires a heel puncture. Which site is appropriate?

   1. AThe central area of the arch of the foot near the midline of the sole
   2. BThe posterior curvature at the back of the heel, nearest the heel bone
   3. CThe tip of the great toe pad on either foot, where blood flow is greatest
   4. DThe lateral or medial plantar surface of the heel, avoiding the posterior curve
   Show answer and explanation▾

   Answer: D. The lateral or medial plantar surface of the heel, avoiding the posterior curve

   Punctures are confined to the medial or lateral plantar heel because the bone is farther from the skin surface there. The posterior curve and the central arch lie close to the calcaneus, nerves and tendons, making injury more likely.

8. Question 8Paediatric Blood Collectionmedium

   What is the maximum recommended lancet penetration depth for a heel puncture in a newborn?

   1. AUp to 3.5 mm to guarantee free flow
   2. BNo more than 2.0 mm, to avoid injuring the heel bone
   3. CUp to 4.0 mm to reach the capillary bed
   4. DUp to 5.0 mm in a larger newborn
   Show answer and explanation▾

   Answer: B. No more than 2.0 mm, to avoid injuring the heel bone

   The calcaneus lies only a few millimetres below the skin, so a depth of 2.0 mm or less is recommended to avoid bone injury and osteomyelitis. A device designed for infants limits penetration and should be single use.

9. Question 9Paediatric Blood Collectionmedium

   A baby needs capillary tubes for a complete blood count (EDTA) and a serum chemistry microtube. How should the capillary samples be collected?

   1. AFill the EDTA microtube first and then the serum microtube
   2. BFill either tube first because the order never affects capillary samples
   3. CFill the serum microtube first so that clotting has time to begin
   4. DFill the serum microtube, then a heparin tube, and the EDTA last
   Show answer and explanation▾

   Answer: A. Fill the EDTA microtube first and then the serum microtube

   Platelets aggregate quickly in capillary blood as it contacts the skin, so the EDTA tube is filled first to preserve an accurate count. Serum tubes are filled last because they contain clot activator.

10. Question 10Paediatric Blood Collectionhard

    A 2.8 kg neonate has an estimated blood volume of 85 mL/kg. Unit policy limits any single collection to 1% of total blood volume. What is the maximum volume that can be drawn?

    1. AAbout 12 mL
    2. BAbout 4.8 mL
    3. CAbout 2.4 mL
    4. DAbout 0.24 mL
    Show answer and explanation▾

    Answer: C. About 2.4 mL

    Total blood volume is 2.8 kg multiplied by 85 mL/kg, or about 238 mL, and 1% of that is about 2.4 mL. Neonatal volumes are limited because even small losses cause iatrogenic anaemia.

11. Question 11Special Collectionshard

    A blood alcohol level is requested for a legal case. Which skin cleanser is appropriate before the venipuncture?

    1. AA 70% ethanol swab applied firmly in a circular motion
    2. BAn alcohol-based chlorhexidine applicator allowed to air dry for thirty seconds
    3. CA 70% isopropyl alcohol pad allowed to dry for thirty seconds
    4. DAqueous chlorhexidine or povidone-iodine, not an alcohol swab
    Show answer and explanation▾

    Answer: D. Aqueous chlorhexidine or povidone-iodine, not an alcohol swab

    Alcohol-containing antiseptics can contaminate the specimen and challenge the validity of the result, so a non-alcohol cleanser is used. The collection must also follow chain of custody procedures.

12. Question 12Donor Collectionmedium

    Which finding in a prospective whole blood donor is a reason for temporary deferral?

    1. AA blood pressure of 125/78 mmHg
    2. BA haemoglobin of 11.5 g/dL in a woman
    3. CA weight of 62 kg in a man
    4. DA resting pulse of 72 beats per minute
    Show answer and explanation▾

    Answer: B. A haemoglobin of 11.5 g/dL in a woman

    Haemoglobin below the accepted minimum, about 12.5 g/dL in many standards, protects the donor from anaemia and results in temporary deferral. The weight, pulse and blood pressure listed are all within acceptable donation limits.

13. Question 13Complications of Blood Collectionmedium

    A patient turns pale and sweaty and says she feels faint while the tubes are filling. What should the phlebotomist do?

    1. AFinish filling the remaining tubes quickly before helping her
    2. BKeep her seated upright and fan her face while the draw continues
    3. CStop, release the tourniquet, remove the needle and lay her flat
    4. DAsk her to stand and walk to a window for some fresh air
    Show answer and explanation▾

    Answer: C. Stop, release the tourniquet, remove the needle and lay her flat

    These are typical signs of impending vasovagal syncope. The procedure is stopped, the needle removed to prevent injury if she faints, and the patient is placed supine so cerebral blood flow is restored.

14. Question 14Ethics and Professional Practiceeasy

    A colleague who is not involved in the care of a patient asks the phlebotomist what the patient's HIV test result was. What is the correct response?

    1. ATell the colleague verbally and make sure that nothing is put in writing
    2. BShare it, since the colleague also works in the same healthcare facility as the patient
    3. CShare it if the colleague promises to keep the result completely secret from others
    4. DDecline, since results go only to authorised members of the care team
    Show answer and explanation▾

    Answer: D. Decline, since results go only to authorised members of the care team

    Patient information is confidential and may be disclosed only to people with a legitimate role in the patient's care or with the patient's consent. Working in the same facility does not create a right of access.

15. Question 15Safetymedium

    A phlebotomist has finished using a needle on a holder with a safety feature. What is the correct immediate action?

    1. ARecap the needle with one hand using the scoop method and discard it at the end of the shift
    2. BActivate the safety device and drop the whole assembly into the sharps container, unrecapped
    3. CRemove the needle with forceps and place it in the general waste bin beside the bed
    4. DUnscrew the needle by hand so that the holder can be reused
    Show answer and explanation▾

    Answer: B. Activate the safety device and drop the whole assembly into the sharps container, unrecapped

    Needles should never be recapped, bent or removed by hand, and the entire single-use device is placed in a puncture-resistant sharps container at the point of use. This approach removes the main cause of occupational needlestick injuries.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.