WorksheetsPhlebotomy NHA Review — Grade 11 Scored Worksheet Questions
Total questions: 113
Worksheet time: 57mins
Aerobic vs. anaerobic blood culture bottles: which bottle must have no air?
Aerobic
Anaerobic
Both
Neither
Before using aerobic/anaerobic bottles, how long should the top be scrubbed with alcohol?
15 seconds
30 seconds
60 seconds
90 seconds
When transferring blood from a yellow tube to anaerobic/aerobic bottles with a syringe, what should you avoid doing with the plunger?
Pull back the plunger to increase vacuum
Push the plunger to force blood
Tap the plunger to remove bubbles
Rotate the plunger while attached
Light Blue tube: which additive is used?
EDTA
Heparin
Sodium Citrate
Sodium Fluoride
Tube order rule: if there is no Yellow tube first, which tube must be filled before the Blue tube?
Green
Red
Purple
Grey
SST (serum separation tube): approximately how long does it take to clot?
5 minutes
15 minutes
30 minutes
60 minutes
RST (rapid serum tube): typical clot time and clotting agent used are which of the following?
30 minutes with calcium
15 minutes with fibrinogen
5 minutes with thrombin
10 minutes with EDTA
Green tube additives include which anticoagulant(s)?
EDTA only
Sodium heparin, ammonia heparin, lithium heparin
Sodium citrate only
Thrombin
Purple tube: which additive does it contain?
Heparin
EDTA
Sodium Citrate
Sodium Fluoride
Blood smears are done with which tube according to the worksheet?
Yellow
Purple
Green
Grey
For a proper blood smear, what should its appearance be on the slide?
Uniform rectangle
Feather-like
Circular pool
Zigzag streak
When making a blood smear per the note, how much blood is used and where is it placed on the slide?
0.1 mm drop at the center
1 mm drop placed on half edge from the side
3 mm drop at the top edge
A large drop covering the slide
Pink tube: which additive is indicated for blood collection?
EDTA
Heparin
Sodium Citrate
Fluoride
Grey tube: which additive is used?
EDTA
Sodium Fluoride
Lithium Heparin
Thrombin
Specimens for glucose testing with a Grey tube should be kept how?
At room temperature
On ice or ice slurry
In a warm pack
Under a heat lamp
Which specimen must be kept warm according to the worksheet?
Ammonia
Cryoglobulin
Lactic acid
PSA
Basal state: approximately how long after last ingestion of food or other nutrition does it occur?
6 hours
8 hours
12 hours
24 hours
Why is order of draw emphasized in the worksheet?
To reduce patient discomfort
To speed up collection
To avoid mixing additives and false test results
To prevent needle clogging
During any patient scenario with a complication while blood is being drawn, what action must be taken first?
Apply a bandage
Notify the provider
Stop the draw
Switch to a smaller needle
Blood types: who is the universal donor?
Type A
Type B
Type O
Type AB
Blood types: who is the universal recipient?
Type A
Type B
Type O
Type AB
If you accidentally stick yourself with a needle, what should you do first according to the worksheet?
Report to supervisor immediately
Apply a tourniquet
Rinse the area for a minimum of 15 minutes
Cover with gauze and continue work
For cutaneous diphtheria (infectious skin ulcers), which PPE/precaution is indicated?
N95 and airborne
Gown with contact precaution
Surgical mask only
Droplet precaution only
For pneumonia, which PPE/precaution is indicated?
Contact only
Airborne only
Mask with droplet precaution
Gloves only
For scabies, which precaution is indicated according to the worksheet?
Droplet
Contact
Airborne
Neutropenic
For tuberculosis (TB), which PPE/precaution is indicated?
Surgical mask with droplet
Gloves only
N95 mask with airborne precaution
Gown with contact precaution
After completing a blood draw in an isolation room, which PPE item should be removed first?
Gown
Mask
Gloves
Face shield
When testing for streptococcal pharyngitis (strep), which transmission-based precaution should be implemented?
Airborne
Contact
Droplet
Enteric
As a phlebotomist needing to input the results of a lab test, which phase is this?
Pre-examination
Exam phase
Post-examination
Quality assurance
Entering critical lab data belongs to which phase?
Pre-examination
Exam phase
Post-examination
Intake
For blood culture collection, how should the site be scrubbed according to the worksheet?
With povidone-iodine for 15 seconds, circular motion
With isopropyl alcohol for 30 seconds, back-and-forth motion
With sterile water for 60 seconds, gentle dabs
With chlorhexidine for 10 seconds, spiral motion
According to OSHA guidance in the worksheet, when dealing with blood, what should be worn at all times?
Mask
Gown
Gloves
Face shield
Joint Commission identification: the worksheet states patients must be identified with at least how many identifiers?
One
Two
Three
Four
CLIA quality control note: external liquid controls for point-of-care tests should be performed when which condition occurs?
Each day at noon
At the end of the week
When a new lot number is used or a kit is opened
Only if a test fails
Safety hazard color coding: which color corresponds to Fire?
Red
Yellow
Blue
White
Safety hazard color coding: which color corresponds to Instability?
Red
Yellow
Blue
White
Safety hazard color coding: which color corresponds to Health?
Red
Yellow
Blue
White
Safety hazard color coding: which color corresponds to Special?
Red
Yellow
Blue
White
To clean a biohazard spill, the worksheet indicates using which bleach-to-water ratio?
1:5
1:10
1:20
1:50
Hemoconcentration is noted to result from which action in the worksheet?
Shaking the tube too vigorously
Leaving a tourniquet on too long
Using an incorrect additive
Fasting longer than 12 hours
To prevent hemolysis per the worksheet, what must be done after applying alcohol to the patient’s arm?
Blow on the site to dry faster
Stick the patient immediately
Allow the site to dry before sticking the patient
Apply extra alcohol just before the stick
Hemostasis is defined in the worksheet as which of the following?
Balance of internal conditions
Stopping of a flow of blood
Destruction of red blood cells
Increase of serum proteins
Homeostasis is defined in the worksheet as which of the following?
Same, steady, stable
Stopping blood flow
Cell rupture
Serum separation
Consent types: which scenario represents implied consent per the worksheet?
Patient signs a consent form
Patient rolls up their sleeve for a blood draw without signing anything
Provider explains risks and benefits
Emergency action documented in chart
Consent types: which item represents informed consent per the worksheet?
Patient rolls up sleeve
Patient signed a consent form
Provider orders a test
Family gives verbal approval
Consent types: during an emergency situation, medical staff assume which type of consent according to the worksheet?
Informed consent
Implied consent
Parental consent
No consent required
In an inpatient (hospital) setting, which two patient identifiers are required according to the worksheet?
Verbal name and date of birth
Verbal name and check that wrist band matches
Verbal name and address
Patient photo and verbal name
In an outpatient setting, which identifiers are noted in the worksheet?
Verbal name and wrist band
Verbal name and patient ID
Patient photo and wrist band
Date of birth and wrist band
For venipuncture, what bevel orientation and insertion angle are indicated?
Bevel down at 45 degrees
Bevel up at 15–30 degrees
Bevel up at 60 degrees
Bevel down at 15 degrees
According to the needles section, which gauge is specified for blood donation?
16 gauge
18 gauge
21 gauge
23 gauge
Which gauges are listed for most other laboratory draws?
14–16 gauge
17–19 gauge
21, 22, 23 gauge
24–26 gauge
For geriatric patients with fragile veins, which needle type is suggested?
Straight needle only
Butterfly needle
Lancet
No difference
What practice is emphasized regarding used needles?
Recap with one-hand technique
Never recap any needles
Always recap before disposal
Recap only butterfly needles
Gross hemolysis in a specimen indicates what according to the worksheet?
Tube mishandling
Wrong needle size used
Patient dehydration
Delayed processing
Under Blood Donation, which gauge needle is noted for donation on this page?
16 gauge
18 gauge
21 gauge
23 gauge
During blood donation, if blood flow stops and the bag is half full, what should be done according to the worksheet?
Continue until full
Clamp and resume later
Dispose of the half-full bag and hang a new bag
Shake the bag to restart flow
Before blood donation, what must be asked of the patient according to the worksheet?
Preferred arm for draw
Complete medical history
Meal preference
Transportation method
A patient with a pulse rate greater than 100 has which donation status per the worksheet?
Eligible to donate with monitoring
Eligible only for plasma
Cannot donate blood
Must donate at a slower rate
Random urine test: what fasting requirement is stated?
Must fast for 12 hours
Must fast for 8 hours
Can be done with or without fasting
Only done postprandially
Urine specimen for pregnancy test: when should the specimen be collected per the worksheet?
Any time of day
First thing in the morning when HCG levels are highest
After lunch
Before bedtime
Clean-catch urine instructions from the worksheet include which steps?
Do not clean; collect immediately
Clean the labia with antiseptic mild soap, void a little into the toilet first, then into the cup
Collect midstream without cleaning
Void completely and then collect droplets
Fasting glucose urine test per the worksheet requires which preparation?
Fast for 8 hours, test once
Fast for 12 hours, then test urine every 1–2 hours
No fasting needed, test after meals
Hydrate and test hourly
Postprandial urine test: what sequence is indicated?
Eat first, then void
Void first, then eat
Fast, then void
Drink water, then void
Urine test with the use of medication: When should the urine be collected after the medication is taken?
Immediately
30 minutes after
2 hours after
24 hours after
24-hour urine test: What is the correct initial step before filling the 3–4 liter container for 24 hours?
Begin filling the container without voiding
Void a little first, then begin collection
Refrigerate the container first
Add preservative after each void
Drug screen urine collection: Which temperature range indicates the specimen is within acceptable limits?
60–70 °F (15–21 °C)
70–85 °F (21–29 °C)
90–100 °F (32–37 °C)
100–110 °F (37–43 °C)
Drug screen urine collection: Which action is emphasized to maintain specimen integrity and legal documentation?
Allow the patient to flush the toilet
Chain of custody is documented and a case number is used
Keep specimen at room temperature for 24 hours
Mix the specimen with tap water to adjust temperature
Buccal test: What specimen is collected for DNA testing?
Blood spot
Cheek swab
Urine sample
Sputum sample
Throat swab collection for strep testing: Where should the swab be directed?
Tongue surface
Inflamed area around the tonsils
Uvula
Inner cheek
Sputum test collection: Which instruction is correct for obtaining the specimen?
Collect at bedtime after a heavy meal
Patient may eat and drink normally
Collect in the morning; patient is NPO and expectorates thick secretions into a container
Swab the throat for secretions
Fecal test handling: Which practice must be avoided when preparing fecal matter for testing?
Checking for parasites
Checking for bacterial infections
Mixing occult blood or urine into the fecal matter
Keeping the specimen sealed
Semen test handling: Which combination of requirements is correct?
Patient must ejaculate daily; refrigerate the specimen; any light is acceptable
Patient cannot ejaculate for 2–7 days; deliver within 2 hours at about 36–38 °C; protect from light; do not refrigerate
Patient cannot ejaculate for 24 hours; freeze immediately; transport within 24 hours
Patient may ejaculate normally; room temperature transport; protect from heat only
Newborn testing timing: When is neonatal testing performed?
Immediately at birth
Within 6–12 hours
Within 24–72 hours after birth
At the first well-child visit
Newborn screening: Which conditions are included in the blood tests?
Cystic fibrosis
Hypothyroid
Phenylketonuria (PKU)
Galactosemia
Sickle cell disease
Blood spot collection on screening cards: What is the correct handling after collection?
Stack cards together to save space
Let blood dry for 4 hours; keep away from heat; ensure the entire circle is full; use the filter side of paper
Refrigerate cards immediately
Blot excess blood with gauze
Heel sticks for babies 1 year old and younger: Where should the puncture be made?
Center of the heel
Medial lateral part of the heel
Arch of the foot
Toe pad
Lancet depth for a baby: What is the correct maximum depth?
1 mm
2 mm
3 mm
4 mm
Maximum level of blood to take from an infant: What percentage of total blood volume is allowed?
0.5%
1%
2%
5%
An infant weighs 3 kg. Using the guideline shown, what is the maximum blood volume to draw?
1 ml
2 ml
3 ml
5 ml
Critical lab results: Which glucose value exceeds the normal range of 70–100 and is considered critical in this list?
80 mg/dL
100 mg/dL
130 mg/dL
60 mg/dL
Specimen handling: Blood gases, ammonia, and lactic acid require which temperature management?
Room temperature in a paper bag
Warm packs in a biohazard bag
Placement on an ice slurry
Freezing at −20 °C
Specimen protection from light: Which tests should be placed in an amber biohazard bag because they are photosensitive?
Vitamin B6 (VB6)
Bilirubin
Folate
Glucose
Ammonia
Patient skin prep: What is the appropriate antiseptic sequence noted?
Betadine only
Alcohol wipe/swab; if allergic to alcohol, use chlorhexidine
Soap and water followed by iodine
No antiseptic is needed
Diabetes with inaccessible veins: Where should blood NOT be drawn?
Hand vein
Forearm vein
Foot
Median cubital vein
Mastectomy on the right side: From which arm should blood be drawn?
Right arm
Left arm
Either arm
Foot
Double mastectomy: Which arm should be used for venipuncture?
Arm of the most recent mastectomy
Arm of the oldest mastectomy
Either arm
Avoid venipuncture entirely
Patient has an IV running on the left arm and a mastectomy on the right arm. What is the correct action?
Proceed without changes
Ask the nurse to shut off the IV and draw under the IV site
Draw from the right arm
Use a foot vein
If a patient has a shunt placed in their arm, what should be done regarding venipuncture on that arm?
Proceed with caution
Always avoid it
Clamp the shunt and draw
Draw only with a butterfly
How long should a patient cool down after running or after a blood pressure measurement before a blood draw?
5 minutes
10 minutes
15 minutes
30 minutes
History of fainting during blood draws: What patient position is recommended before venipuncture?
Standing upright
Sitting upright
Reclining position (semi-Fowler’s)
Prone position
A patient says they feel like they are going to faint during a draw. What is the immediate action?
Continue drawing quickly
Stop the draw and have the patient put their head between their knees
Lay the patient flat and continue drawing
Offer water and proceed
A report of nausea is described as what in this context?
Syncope
Lightheadedness
Shock
Convulsion
Seizures are defined as what kind of movement?
Voluntary
Involuntary
Rhythmic voluntary
Intentional
What does SD stand for?
Standard dose
Standard deviation
Sample deviation
Statistical difference
Patient in shock: Which set of actions is recommended?
Give food immediately
Keep airways open, control bleeding, and keep the patient warm
Lay the patient prone and wait
Elevate legs only
If a patient is convulsing, what should you do?
Stand them up
Lay them down
Restrain their limbs tightly
Offer cold water
If a patient is vomiting, what position and care should be provided?
Supine; warm compress
On their side; apply cool compress
Prone; no compress
Seated; warm compress
Interaction levels: Which setting corresponds to performing venipuncture?
Social
Public
Intimate
Personal
Interaction levels: Which setting corresponds to explaining procedures to a patient?
Public
Personal
Social
Intimate
Requisition forms for a blood draw: What is the requirement?
Carry multiple requisitions to be safe
Always make sure you have only one requisition form
Verbal orders are sufficient
Use the patient’s room number as the requisition
STAT orders: What is the required response time?
Within 1 hour
Within 30 minutes
Answer immediately
By end of shift
In obese patients, which vein is noted as easier to locate?
Basilic
Median cubital
Median cephalic
Dorsal hand vein
Device selection: When is a syringe preferred?
Routine draws
Multiple tests
Fragile or collapsed veins
Large antecubital veins
Device selection: For which patients or purposes is a lancet used?
Adults with large veins
Infants or diabetes finger sticks
Central lines
Arterial draws
Device selection: What vein type is appropriate for a butterfly needle?
Large veins
Small veins
Arteries
Shunted veins
Order of preferred veins for venipuncture is noted. Which order is correct?
Basilic, median cubital, cephalic
Cephalic, basilic, median cubital
Median cubital, cephalic, basilic (last resort)
Cephalic, median cubital, basilic
Syncope is described as what, and what commonly precedes it?
Vomiting; nausea
Passing out or fainting; dizziness
Convulsing; headache
Shock; hypothermia
Accessing a patient for a capillary draw: What is the correct angle or approach?
Parallel to the fingertip
Diagonal across the fingertip
Perpendicular from the fingertip
Along the nail bed
Drawing multiple tests in one setup: What system should be used?
Syringe and transfer device
Evacuated tube system
Capillary tubes
Single-use pipettes
Venous draw on a preschooler: What communication is required?
No explanation is necessary
Explain the procedure to the parent and child; tell the child they will feel a small prick
Only speak to the parent
Provide written instructions later
A winged evacuated system is characterized by which needle gauge range?
18–20 gauge
21–22 gauge
23–25 gauge
26–28 gauge
Labeling a specimen from an unconscious and unidentified patient: What should be confirmed before drawing and labeling?
Proceed with any available name
Wait for an identification bracelet; or confirm that the patient’s room number and the name on the door agree with the request
Use a temporary generic ID
Skip labeling until later
Other knowledge item noted: What protocol should be known?
Blood bank crossmatch protocol
Aseptic technique protocol
Dialysis protocol
Radiology transport protocol
