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NHA CPT practice questions

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Question 1Safety and Compliance

A phlebotomist is about to draw blood from a patient. Which action best demonstrates proper hand hygiene immediately before donning gloves?

  1. Apply hand lotion and then put on gloves without washing
  2. Put on gloves first, then wipe them with an alcohol pad
  3. Rinse hands with water only and shake dry before gloving
  4. Wash hands with soap and water or use alcohol-based hand rub, then apply gloves Correct answer.

Explanation

Hand hygiene must be performed before gloves are donned because gloves do not replace handwashing and can harbor organisms if hands are contaminated. Soap and water or an alcohol-based rub are both acceptable when hands are not visibly soiled. Gloves are then applied to clean hands.

Question 2Safety and Compliance

Which piece of personal protective equipment is required when there is a risk of blood splashing into the eyes during a procedure?

  1. A lead apron
  2. Shoe covers only
  3. Protective eyewear or a face shield Correct answer.
  4. A surgical mask alone

Explanation

When splash or spray exposure to the eyes is anticipated, protective eyewear or a face shield covering the eyes is required. A standard mask alone does not protect the eyes. This is part of standard precautions for exposure control.

Question 3Safety and Compliance

A patient's blood specimen tube breaks and spills onto the counter. What is the correct first step in cleanup?

  1. Spray disinfectant from a distance and leave it overnight
  2. Wipe the spill with a dry paper towel and continue working
  3. Don gloves and other PPE, then contain and absorb the spill before disinfecting Correct answer.
  4. Call housekeeping and leave the area without marking it

Explanation

Spill cleanup begins with donning appropriate PPE to prevent exposure, then containing and absorbing the material, followed by disinfection of the area with an appropriate disinfectant. Working without PPE or leaving the spill unmarked creates exposure risk. Proper containment prevents the spill from spreading.

Question 4Safety and Compliance

Which statement correctly describes the use of standard precautions in a collection setting?

  1. They are used only when the patient requests them
  2. They apply only to invasive surgical procedures
  3. They apply only to patients with diagnosed bloodborne infections
  4. They apply to all patients regardless of known infection status Correct answer.

Explanation

Standard precautions are applied to every patient because infection status is often unknown and cannot be assumed. They treat all blood and body fluids as potentially infectious. This uniform approach protects both patients and staff.

Question 5Safety and Compliance

A phlebotomist sustains a needlestick injury. Which sequence reflects accepted post-exposure practice?

  1. Squeeze the wound firmly to express blood, then ignore it if bleeding stops
  2. Apply bleach directly to the puncture and finish the shift before reporting
  3. Cover the site and report at the end of the week
  4. Wash the site with soap and water, report immediately, and seek source evaluation and follow-up care Correct answer.

Explanation

After a needlestick, the site should be washed with soap and water, the exposure reported promptly, and the source patient evaluated so appropriate post-exposure prophylaxis and follow-up can begin. Prompt reporting is essential because prophylaxis is time-sensitive. Bleach and aggressive squeezing are not recommended.

Question 6Safety and Compliance

Which action is the most effective way to prevent a sharps injury when disposing of a used needle?

  1. Recap the needle using two hands before disposal
  2. Activate the safety device and place the needle directly into the sharps container without recapping Correct answer.
  3. Bend the needle before placing it in the container
  4. Place the needle in a biohazard bag with other waste

Explanation

The safest practice is to activate the engineered safety device and dispose of the needle immediately into a puncture-resistant sharps container without recapping. Recapping, bending, or breaking needles increases the risk of injury. Sharps must never go into regular biohazard bags.

Question 7Safety and Compliance

How full may a sharps container be before it must be replaced?

  1. It may be filled to the very top before sealing
  2. It should be replaced when it reaches about three-quarters full Correct answer.
  3. It may be overfilled if the lid still closes
  4. It only needs replacement when a needle protrudes

Explanation

Sharps containers are replaced when approximately three-quarters full to prevent overfilling and accidental injury during disposal. Overfilling risks protruding needles and difficulty closing the container. Containers should be sealed and replaced before they are full.

Question 8Safety and Compliance

A phlebotomist is collecting blood from a patient under airborne precautions for suspected tuberculosis. Which action is appropriate?

  1. Perform the collection while wearing a fit-tested N95 respirator and following the facility's isolation protocol Correct answer.
  2. Remove the respirator once inside the closed room
  3. Enter the room without a respirator because the draw is quick
  4. Ask the patient to hold their breath during the draw

Explanation

Airborne precautions require respiratory protection such as a fit-tested N95 respirator, along with adherence to the facility's isolation procedures. A quick procedure does not eliminate airborne exposure risk. Standard surgical masks are insufficient for airborne pathogens.

Question 9Safety and Compliance

Which patient identifier combination is acceptable for verifying identity before a blood collection?

  1. Patient's stated first name only
  2. Insurance number alone
  3. Room number and bed location
  4. Full name and date of birth confirmed from the patient and requisition Correct answer.

Explanation

At least two independent identifiers, such as full name and date of birth, must match between the patient and the requisition. Location-based identifiers like room or bed number are not acceptable because patients can be moved. A single identifier is insufficient.

Question 10Safety and Compliance

A patient becomes pale and sweaty and reports feeling faint during the draw. What is the most appropriate immediate response?

  1. Continue the draw quickly to finish before the patient faints
  2. Ignore the symptoms and complete the collection
  3. Stop the draw, protect the patient from falling, and position them safely until recovery Correct answer.
  4. Have the patient stand up and walk to another room

Explanation

When a patient shows signs of syncope, the collection should stop and the patient should be protected from injury and positioned safely, such as lying down. Continuing the draw or having the patient stand increases the risk of falling and injury. Patient safety takes priority over completing the collection.

Question 11Safety and Compliance

Which statement about the use of gloves during a venipuncture is correct?

  1. Gloves are worn for the procedure and changed between patients Correct answer.
  2. One pair of gloves may be worn for an entire shift
  3. Gloves are unnecessary if the phlebotomist's hands are clean
  4. Gloves may be reused after washing with alcohol

Explanation

Gloves are worn for the procedure and must be changed between patients to prevent cross-contamination. Gloves are single-use and are not washed or reused. Clean hands do not eliminate the need for gloves during blood collection.

Question 12Safety and Compliance

After completing a blood collection, what is the correct order of doffing personal protective equipment?

  1. Remove gloves and place them on the patient's table
  2. Remove gloves first, then perform hand hygiene, then remove other PPE as indicated Correct answer.
  3. Remove all PPE at once and place it on the counter
  4. Remove the mask first, then the gloves

Explanation

Gloves are the most contaminated item and are removed first, followed by hand hygiene and removal of other PPE according to protocol. Removing the mask first or setting used gloves on surfaces spreads contamination. Used PPE must be discarded properly, not placed on patient areas.

Question 13Safety and Compliance

Which of the following best describes the purpose of an exposure control plan?

  1. To list patient billing codes
  2. To outline measures that reduce occupational exposure to bloodborne pathogens Correct answer.
  3. To describe marketing procedures for the laboratory
  4. To document employee vacation schedules

Explanation

An exposure control plan is a written program that identifies tasks with exposure risk and specifies the protective measures, training, and procedures to reduce occupational exposure to bloodborne pathogens. It is a safety document, not an administrative or billing record. It supports compliance with occupational safety requirements.

Question 14Safety and Compliance

Which practice is required when labeling a blood specimen at the bedside?

  1. Label the tubes later at the desk from memory
  2. Label only the requisition and not the tubes
  3. Label tubes before entering the room using the previous patient's information
  4. Label the tube after confirming identity at the patient's side before leaving Correct answer.

Explanation

Specimens must be labeled at the patient's side after confirming identity to prevent mislabeling and wrong-patient errors. Labeling later from memory or labeling before identity confirmation increases the risk of error. Accurate bedside labeling is a core safety requirement.

Question 15Safety and Compliance

A phlebotomist has a small cut on the hand. What is the appropriate action before performing patient collections?

  1. Leave the cut uncovered so it can air out
  2. Cover the cut with a bandage and wear gloves as usual Correct answer.
  3. Apply a bandage over the gloves after donning them
  4. Avoid gloves so the cut stays dry

Explanation

Open cuts on the hands must be covered with a bandage and gloves worn to prevent both contamination of the wound and transmission of organisms to the patient. Leaving a wound uncovered or skipping gloves creates an exposure risk. Bandages are applied to the skin before gloving.

Question 16Safety and Compliance

Which disinfectant property is most important for decontaminating surfaces after a blood spill?

  1. It dries instantly on contact
  2. It has a pleasant fragrance
  3. It is the least expensive option available
  4. It is effective against bloodborne pathogens when used at the correct concentration and contact time Correct answer.

Explanation

An appropriate disinfectant must be effective against bloodborne pathogens and be used at the correct concentration and contact time. Fragrance, cost, and fast drying are not indicators of efficacy. Proper contact time is essential for the disinfectant to work.

Question 17Safety and Compliance

A patient tells the phlebotomist they have a bleeding disorder and are taking an anticoagulant. What is the most appropriate action?

  1. Apply minimal pressure and release immediately
  2. Skip pressure entirely to avoid bruising
  3. Apply firm pressure for a longer period after the draw and monitor for bleeding Correct answer.
  4. Use a larger needle to speed the draw

Explanation

Patients on anticoagulants or with bleeding disorders require longer, firm pressure after venipuncture to prevent hematoma and prolonged bleeding. Minimal or no pressure increases the risk of bleeding and bruising. The site should be monitored until bleeding stops.

Question 18Safety and Compliance

Which action reflects proper handling of a blood specimen that may contain a bloodborne pathogen during transport?

  1. Carry it uncovered in a hand
  2. Place it loosely in a pocket
  3. Place it in a leak-proof secondary container with the requisition Correct answer.
  4. Attach the requisition with a paper clip to the open tube

Explanation

Specimens should be transported in a leak-proof secondary container to contain spills and protect handlers. Carrying tubes uncovered or in a pocket risks breakage and exposure. Requisitions should be kept with the specimen but not attached in a way that compromises the tube.

Question 19Safety and Compliance

What is the primary reason for wearing a laboratory coat or gown during procedures with splash risk?

  1. To replace the need for gloves
  2. To protect clothing and skin from blood and body fluid contamination Correct answer.
  3. To keep the phlebotomist warm
  4. To identify the phlebotomist's job title

Explanation

A laboratory coat or gown provides a barrier that protects skin and clothing from blood and body fluid contamination. It does not replace gloves or other PPE. Its purpose is barrier protection, not warmth or identification.

Question 20Safety and Compliance

A phlebotomist notices that a sharps container in a patient room is overflowing. What is the most appropriate action?

  1. Seal and replace the container according to facility policy and report the issue Correct answer.
  2. Continue using it until a supervisor notices
  3. Push the contents down to make room for more sharps
  4. Empty the container into a biohazard bag

Explanation

An overflowing sharps container presents an injury hazard and should be sealed and replaced following facility policy, with the issue reported. Pushing contents down or continuing to use it increases needlestick risk. Sharps are never emptied into bags by hand.

Question 21Safety and Compliance

Which factor most directly determines whether a task requires the use of personal protective equipment?

  1. The anticipated risk of exposure to blood or body fluids Correct answer.
  2. The patient's age
  3. The phlebotomist's seniority
  4. The time of day the task is performed

Explanation

PPE selection is based on the anticipated risk of exposure to blood or body fluids for a given task. Age, time of day, and seniority do not determine exposure risk. This risk-based approach is central to standard precautions.

Question 22Safety and Compliance

A patient refuses to allow a blood draw. What is the most appropriate response?

  1. Proceed with the draw because it was ordered
  2. Respect the refusal, document it, and notify the appropriate care provider Correct answer.
  3. Restrain the patient's arm to complete the draw
  4. Tell the patient the draw is legally required

Explanation

A competent patient has the right to refuse a procedure, and the refusal should be respected, documented, and communicated to the care provider. Proceeding against the patient's wishes or restraining them violates patient autonomy and consent. Consent is required before collection.

Question 23Safety and Compliance

Which statement about the use of alcohol-based hand rub is correct?

  1. It is effective when hands are not visibly soiled and is rubbed until dry Correct answer.
  2. It should be used only after gloves are removed and hands are visibly soiled
  3. It should be wiped off immediately after application
  4. It replaces the need to wash hands when hands are visibly soiled

Explanation

Alcohol-based hand rub is appropriate when hands are not visibly soiled and should be rubbed in until dry to achieve effective reduction of organisms. When hands are visibly soiled, soap and water are required. Wiping it off before drying reduces effectiveness.

Question 24Safety and Compliance

A phlebotomist is asked to collect blood from a patient in a room with a contact precaution sign. Which action is correct?

  1. Ignore the sign because blood collection is a brief procedure
  2. Enter without PPE and wash hands only afterward
  3. Remove the sign since the phlebotomist is not a nurse
  4. Follow the posted precautions, including appropriate PPE and equipment handling, before entering Correct answer.

Explanation

Posted precautions must be followed by all staff entering the room, including phlebotomists, with appropriate PPE and equipment handling. Procedure brevity does not exempt a caregiver from precautions. Removing signage is outside the phlebotomist's role and is unsafe.

Question 25Safety and Compliance

Which practice best reduces the risk of a wrong-blood-in-tube error during a busy shift?

  1. Rely on remembering which tube belongs to which patient
  2. Collect from several patients and label all tubes afterward
  3. Pre-label tubes for upcoming patients in advance
  4. Complete identification and bedside labeling for one patient before moving to the next Correct answer.

Explanation

Completing identification and labeling for each patient before moving on prevents tubes from being mixed up. Batch labeling or pre-labeling introduces wrong-patient errors. Memory is not a reliable substitute for immediate bedside labeling.

Question 26Safety and Compliance

Under the Bloodborne Pathogens Standard, how soon after an occupational exposure to blood must the employer offer the employee a confidential medical evaluation and follow-up?

  1. Immediately after the employee reports the exposure Correct answer.
  2. Within 24 hours of the exposure
  3. Within 5 business days of the exposure
  4. Within 30 days of the exposure

Explanation

The Bloodborne Pathogens Standard requires the employer to make a confidential post-exposure medical evaluation and follow-up available to the exposed employee immediately after the incident is reported, at no cost to the worker. Delaying evaluation beyond the immediate reporting period is not permitted because timely prophylaxis can depend on prompt assessment.

Question 27Safety and Compliance

A phlebotomist is exposed to blood through a needlestick. Which action should be taken first?

  1. Complete an incident report before doing anything else
  2. Apply a tight tourniquet above the injury
  3. Squeeze the puncture site firmly to express blood
  4. Wash the site with soap and water and report the exposure promptly Correct answer.

Explanation

Immediate care is to wash the exposed site thoroughly with soap and water, then report the exposure promptly so post-exposure evaluation can begin. Squeezing, cauterizing, or applying caustic agents is not recommended because it can further damage tissue without reducing transmission risk.

Question 28Safety and Compliance

Which element must a facility's exposure control plan include?

  1. The schedule for implementing safer medical devices and methods of compliance Correct answer.
  2. The annual budget for the infection control department
  3. A list of patients known to carry bloodborne pathogens
  4. The names of employees who have declined hepatitis B vaccination

Explanation

The exposure control plan must document the methods of compliance, including the schedule for implementing safer medical devices and engineering controls, along with exposure determination and procedures for evaluation and follow-up. It is a living document reviewed at least annually and updated when new tasks or devices change exposure risk.

Question 29Safety and Compliance

A phlebotomist must enter a room marked with a droplet precautions sign. Which action is required before entering?

  1. Wear only gloves and a face shield
  2. Wear a surgical mask and perform hand hygiene Correct answer.
  3. Wear a powered air-purifying respirator
  4. Wear an N95 respirator and a gown

Explanation

Droplet precautions require a surgical mask for entry plus hand hygiene, because large respiratory droplets travel only a short distance and do not require airborne-level respiratory protection. An N95 or PAPR is reserved for airborne precautions such as suspected tuberculosis or measles.

Question 30Safety and Compliance

Which action is appropriate when a phlebotomist must draw blood from a patient under protective (reverse) isolation?

  1. Reuse the same tourniquet from the previous patient without cleaning
  2. Skip hand hygiene to avoid introducing organisms into the room
  3. Follow standard precautions and any posted precautions, using clean technique and dedicated equipment Correct answer.
  4. Remove the isolation sign so other staff are not confused

Explanation

Protective isolation shields an immunocompromised patient from outside organisms, so the collector follows standard precautions and any posted instructions, uses clean or dedicated equipment, and performs hand hygiene. Hand hygiene and equipment disinfection are never waived, even though the goal is protecting the patient rather than the worker.

Question 31Safety and Compliance

Which statement about hand hygiene before and after gloved venipuncture is correct?

  1. Gloves may be washed with soap and water and reused for the next patient
  2. Hand hygiene is unnecessary if gloves are worn for the entire procedure
  3. Alcohol-based rub should be applied directly onto soiled gloves
  4. Hand hygiene is performed before donning gloves and after removing them Correct answer.

Explanation

Gloves do not replace hand hygiene; hands must be cleaned before donning and after removing gloves, because gloves can have unnoticed microperforations and hands can be contaminated during removal. Washing or disinfecting gloves for reuse is prohibited because it damages the glove barrier.

Question 32Safety and Compliance

A used lancet is dropped on the floor during a capillary collection. What is the correct sequence for handling it?

  1. Pick it up with gloved fingers and place it in the regular trash
  2. Use a mechanical device such as forceps or tongs to place it in a sharps container Correct answer.
  3. Kick it under a cabinet and continue with the collection
  4. Ask the patient to pick it up and hand it back

Explanation

A contaminated sharp on the floor must be retrieved with a mechanical tool such as tongs or forceps, never with the hands, and placed directly into a sharps container. Recapping or hand retrieval of loose sharps is a leading cause of needlestick injuries.

Question 33Safety and Compliance

What information must appear on the label of a blood specimen collected for transfusion pre-testing?

  1. The patient's date of birth and the test ordered only
  2. The patient's diagnosis and physician name
  3. Patient name, unique identifier, date and time of collection, and collector identification Correct answer.
  4. Patient room number and insurance number only

Explanation

Specimen labels for pretransfusion testing must carry two independent patient identifiers, the date and time of collection, and the identity of the person who collected the specimen, applied at the bedside after collection. These elements allow the transfusion service to trace the sample to the correct patient and collector.

Question 34Safety and Compliance

A phlebotomist is collecting blood from a patient with a known latex allergy. Which action is most appropriate?

  1. Double the latex gloves to create a barrier
  2. Use non-latex gloves and latex-free supplies such as tourniquets Correct answer.
  3. Use latex gloves but remove them quickly
  4. Proceed without gloves since contact time is brief

Explanation

For a latex-allergic patient, the collector should use latex-free gloves and latex-free equipment such as tourniquets, because allergens can transfer from the collector's gloves and supplies to the patient's skin. Skipping gloves or layering latex does not eliminate the allergen and may worsen the reaction.

Question 35Safety and Compliance

Which action best prevents contamination of the phlebotomist's hands with blood during a difficult draw?

  1. Washing gloved hands with bleach between patients
  2. Wearing rings under the gloves for grip
  3. Using the same gloves for multiple patients in one room
  4. Wearing gloves that fit properly and changing them when visibly contaminated Correct answer.

Explanation

Properly fitted gloves create an intact barrier, and gloves must be changed as soon as they become visibly contaminated or torn to prevent blood from reaching the skin. Jewelry and reuse of gloves both compromise the barrier and increase contact with blood.

Question 36Safety and Compliance

A blood specimen tube cracks and leaks inside a biohazard transport bag. What is the correct initial action?

  1. Discard the entire bag into regular trash
  2. Rinse the bag under a faucet in the collection area
  3. Place the bag inside a secondary leakproof container and follow spill procedures Correct answer.
  4. Open the bag and remove the broken tube with bare hands

Explanation

A leaking specimen must be contained by placing it in a secondary leakproof container before transport or disposal, and the spill is then decontaminated according to facility procedure. Broken contaminated glass is never handled with bare hands, and biohazardous waste cannot go into regular trash.

Question 37Safety and Compliance

Which practice is required when storing blood collection supplies in the phlebotomy area?

  1. Allow supplies to sit directly on the floor for easy access
  2. Store clean needles next to the biohazard waste bin for convenience
  3. Store food and beverages beside the specimen refrigerator
  4. Keep supplies in a clean area separated from contaminated waste and specimens Correct answer.

Explanation

Clean supplies must be stored in a clean area separated from contaminated items such as specimens and biohazard waste to prevent cross-contamination. Food and drink are prohibited in work areas where blood exposure is possible.

Question 38Safety and Compliance

A phlebotomist is asked to draw blood from an uncooperative, combative patient who is pulling away. What is the safest course of action?

  1. Ask another patient to help hold the arm still
  2. Stop the procedure and seek help or defer the draw until the patient can be safely positioned Correct answer.
  3. Draw from the patient's foot instead of the arm
  4. Proceed quickly while an assistant restrains the arm tightly

Explanation

When a patient cannot cooperate, the collector should stop and obtain appropriate assistance or defer the collection, because struggling increases the risk of needlestick injury to staff and injury to the patient. Restraint or another patient holding the arm is not an acceptable substitute for proper staff assistance and consent.

Question 39Safety and Compliance

What is the correct action when a patient reports taking warfarin and has a history of prolonged bleeding after prior draws?

  1. Use a smaller needle and apply pressure longer than usual after the draw Correct answer.
  2. Apply a tourniquet for several minutes to control bleeding
  3. Skip pressure and bandage immediately
  4. Draw from the antecubital vein with a larger needle to speed the draw

Explanation

For a patient on anticoagulant therapy with a bleeding history, the collector should minimize trauma, use an appropriate needle, and apply firm pressure for longer than usual after the draw to prevent hematoma formation. Prolonged tourniquet use and rushing with a larger needle both increase bleeding and hematoma risk.

Question 40Safety and Compliance

Which action is appropriate when a phlebotomist must draw blood from a patient in an airborne infection isolation room for suspected measles?

  1. Ask the patient to come to the hallway for the draw
  2. Wear a surgical mask and leave the door open
  3. Enter with only gloves and a gown
  4. Wear an N95 respirator and keep the door closed per posted precautions Correct answer.

Explanation

Airborne precautions for agents such as measles require an N95 or higher respirator and a negative-pressure room with the door closed. Bringing the patient into a hallway or leaving the door open defeats the room's containment and exposes others.

Question 41Safety and Compliance

A phlebotomist spills a small amount of blood on a work counter. Which sequence follows accepted decontamination practice?

  1. Pour undiluted bleach directly on the counter and wipe immediately
  2. Rinse with water only and continue working
  3. Absorb the spill, clean with detergent, then apply an EPA-registered disinfectant with the correct contact time Correct answer.
  4. Wipe with a dry paper towel, then leave the surface to air dry

Explanation

Spill cleanup involves absorbing the visible material, cleaning the surface, and then applying an EPA-registered disinfectant effective against bloodborne pathogens for the manufacturer's stated contact time. Immediate wiping of disinfectant or rinsing with water alone does not provide the required kill time.

Question 42Safety and Compliance

Which statement correctly describes the employer's responsibility for providing hepatitis B vaccination to at-risk employees?

  1. Employees must purchase the vaccine and seek reimbursement
  2. Vaccination is required for all employees regardless of exposure risk
  3. The vaccine is offered only after the employee has a needlestick
  4. The vaccine must be offered at no cost within 10 working days of initial assignment Correct answer.

Explanation

The Bloodborne Pathogens Standard requires the employer to offer hepatitis B vaccination at no charge to employees with occupational exposure within 10 working days of initial assignment, after appropriate training. Employees may decline by signing a declination form but may later request the vaccine.

Question 43Safety and Compliance

A phlebotomist develops a rash and itching after wearing latex gloves. What is the most appropriate action?

  1. Report the symptoms and switch to non-latex gloves Correct answer.
  2. Double-glove with latex for extra protection
  3. Ignore the symptoms until they become severe
  4. Continue using latex gloves but apply lotion first

Explanation

Signs of latex sensitivity should be reported so the employer can provide non-latex gloves and evaluate the worker, since continued exposure can worsen the allergy. Lotions and double-gloving do not prevent the reaction and may increase allergen contact.

Question 44Safety and Compliance

Which action best protects a phlebotomist from splashes to the eyes during a draw from an agitated patient?

  1. Wear a cloth surgical cap
  2. Close the eyes briefly during needle removal
  3. Turn the head away during the draw
  4. Wear safety glasses or goggles with side protection Correct answer.

Explanation

Eye protection with side shields or goggles provides a barrier against splashes of blood to the conjunctiva, which is a mucous membrane exposure route. Turning away or closing the eyes does not stop droplets from reaching the eye.

Question 45Safety and Compliance

A patient asks why the phlebotomist is wearing a gown and mask for a routine draw. Which response is most accurate?

  1. The equipment is worn only to satisfy administrative paperwork
  2. Gowns and masks are required for every blood draw regardless of risk
  3. The equipment is worn because the patient has a contagious disease
  4. Personal protective equipment is selected based on the anticipated exposure risk and any posted precautions Correct answer.

Explanation

PPE selection is based on the task and the anticipated exposure risk, plus any transmission-based precautions posted for the patient. Routine venipuncture typically requires gloves, while gowns, masks, and eye protection are added when splash or spray is anticipated.

Question 46Safety and Compliance

A phlebotomist receives a verbal order to collect a specimen from a patient with no armband and no chart available. What is the most appropriate action?

  1. Collect the specimen and label it later using the room number
  2. Proceed because the order came from a physician
  3. Ask the patient to state their name and date of birth, then verify against a reliable source before collecting Correct answer.
  4. Label the tube with the ordering physician's name

Explanation

Positive patient identification requires two independent identifiers verified against a reliable source before collection; a verbal order does not replace identification. If identification cannot be confirmed, the collector should stop and resolve the discrepancy with the care team before drawing.

Question 47Safety and Compliance

Which situation represents a breach of standard precautions that should be corrected immediately?

  1. A phlebotomist wearing gloves while palpating a vein after cleaning the site
  2. A phlebotomist performing hand hygiene before and after each patient
  3. A phlebotomist placing a used needle directly into a sharps container
  4. A phlebotomist eating a snack at the specimen processing bench Correct answer.

Explanation

Eating in an area where specimens are handled is prohibited because it creates a route for ingestion of bloodborne pathogens and violates the restriction on food and drink in exposure-prone work areas. The other listed actions are consistent with safe practice.

Question 48Safety and Compliance

A phlebotomist is assigned to collect from a patient whose chart shows a history of multidrug-resistant organism infection and an active wound drainage. Which combination of precautions is most appropriate?

  1. Standard precautions only, since the drainage is covered
  2. Droplet precautions with a surgical mask only
  3. Standard precautions plus contact precautions, with gloves and gown for room entry Correct answer.
  4. Airborne precautions with an N95 respirator

Explanation

Multidrug-resistant organisms spread by contact, so standard precautions are combined with contact precautions, including gloves and a gown for room entry and hand hygiene on exit. Airborne and droplet precautions address respiratory transmission, not wound drainage contact spread.

Question 49Safety and Compliance

A phlebotomist notices a colleague recapping a needle using two hands. What is the most appropriate response?

  1. Take the needle and recap it personally
  2. Remind the colleague that recapping should be avoided and offer a one-handed scoop method only if recapping is unavoidable Correct answer.
  3. Ignore it because recapping is permitted with two hands
  4. Report the colleague to the patient

Explanation

Recapping with two hands is a leading cause of needlestick injuries and should be avoided entirely; if recapping is truly necessary, a one-handed scoop method or a recapping device is used. The appropriate response is a direct, respectful reminder that reinforces the safety rule.

Question 50Safety and Compliance

Which action best demonstrates compliance with the requirement to use safer medical devices when available?

  1. Selecting a needle with a safety-engineered shielding device for venipuncture Correct answer.
  2. Recapping a standard needle with one hand after use
  3. Reusing a standard needle after wiping it with alcohol
  4. Choosing a butterfly needle without a safety feature because it is cheaper

Explanation

When a safety-engineered device is available and appropriate, the collector must use it to reduce needlestick risk. Choosing a non-safety device for cost or convenience, or reusing a needle, defeats the engineering control.