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Phlebotomy study materials
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Phlebotomy practice questions

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Question 1Safety and Compliance

Under standard precautions, when must a phlebotomist perform hand hygiene?

  1. Only at the beginning and end of a shift
  2. Only when hands are visibly soiled
  3. Only before entering a patient room
  4. Before and after each patient contact Correct answer.

Explanation

Hand hygiene is required before and after every patient contact and again after gloves are removed, even when gloves were worn. Gloves do not replace hand washing because unnoticed tears and contamination during removal can leave hands infectious.

Question 2Safety and Compliance

When should a phlebotomist replace a sharps container?

  1. When the container has been in use for 24 hours
  2. When it is about three-quarters full Correct answer.
  3. When the manufacturer's expiration date passes
  4. Only after it has been dropped on the floor

Explanation

Sharps containers are replaced when they are about three-quarters full, before contents reach the fill line. Overfilling lets items protrude and forces users to reach into the container, which is a leading cause of disposal injuries.

Question 3Safety and Compliance

What is the correct handling of a used blood collection needle?

  1. Place it directly in a sharps container Correct answer.
  2. Put it in a biohazard bag with the specimen
  3. Recap it using two hands before carrying it to the sharps container
  4. Bend the needle so that it cannot be reused

Explanation

Used needles go straight into a puncture-resistant sharps container at the point of use. Recapping, bending, and breaking are prohibited because they bring the hands into the path of the needle.

Question 4Safety and Compliance

Under the OSHA Bloodborne Pathogens Standard, when must an employer offer the hepatitis B vaccination to a newly hired phlebotomist with occupational exposure?

  1. Within 10 working days of initial assignment Correct answer.
  2. After the employee's first needlestick
  3. At the end of a six-month probation period
  4. Within 90 days of hire

Explanation

The standard requires the hepatitis B vaccination to be offered at no charge within 10 working days of initial assignment to employees who have occupational exposure. The employee may decline by signing a declination form and can later request the series.

Question 5Safety and Compliance

Which pair of identifiers is acceptable for verifying a patient before venipuncture?

  1. Physician's name and diagnosis
  2. Specimen label color and test order
  3. Full name and date of birth Correct answer.
  4. Room number and bed number

Explanation

Two independent identifiers, such as the patient's full name and date of birth, must match the requisition and the label before collection. Location or clinical details are not unique to one person and cannot confirm identity.

Question 6Safety and Compliance

A container holding a blood specimen must carry which of the following when it leaves the collection area?

  1. A biohazard symbol and label Correct answer.
  2. The patient's room number and bed number
  3. A 'fragile' handling sticker in red
  4. The phlebotomist's employee identification number

Explanation

Containers leaving the collection area must be marked with the biohazard symbol and a warning term so that anyone who handles them knows the contents are potentially infectious. The label must remain legible on the outermost container.

Question 7Safety and Compliance

When should a phlebotomist wear gloves?

  1. Only during the venipuncture itself, then removed immediately
  2. Only when the phlebotomist has an open cut on the hand
  3. Only when the patient has a known infectious disease
  4. For every contact with blood or body fluids Correct answer.

Explanation

Gloves are worn whenever contact with blood, body fluids, or contaminated surfaces is anticipated, which includes every venipuncture. Standard precautions assume every patient may carry a bloodborne pathogen.

Question 8Safety and Compliance

When is it acceptable to eat or drink in the specimen collection area?

  1. Never in the work area Correct answer.
  2. When no patients are present
  3. Only during scheduled breaks
  4. When food is kept in a closed container

Explanation

Eating and drinking are prohibited at all times in work areas where blood or other potentially infectious materials are present, because contaminated hands and surfaces can lead to ingestion.

Question 9Safety and Compliance

OSHA requires that an employer's written Exposure Control Plan be reviewed and updated at least how often?

  1. Only when a new employee is hired
  2. Every 3 years
  3. Every 12 months Correct answer.
  4. Every 5 years

Explanation

The Exposure Control Plan must be reviewed and updated at least every 12 months and whenever new tasks, procedures, or devices change the risk of exposure.

Question 10Safety and Compliance

Immediately after a needlestick with a contaminated needle, what is the correct first action?

  1. Seal the puncture with tissue adhesive
  2. Scrub the wound with a bleach solution
  3. Wash the site with soap and water Correct answer.
  4. Apply a tourniquet above the site

Explanation

The exposed site is washed with soap and water and then reported so that evaluation and post-exposure prophylaxis can begin promptly. Caustic agents and squeezing or sealing the wound are not appropriate first aid.

Question 11Safety and Compliance

Which item must be recorded in the Sharps Injury Log?

  1. The patient's insurance provider
  2. The purchase cost of the device
  3. The type and brand of the device involved Correct answer.
  4. The phlebotomist's annual performance rating

Explanation

The Sharps Injury Log records the type and brand of device involved, the work area where the injury occurred, and an explanation of how it happened. This information lets the employer identify hazardous devices and practices.

Question 12Safety and Compliance

After visible material is removed from a small blood spill on a work surface, which bleach dilution is standard for disinfection?

  1. One part bleach to fifty parts water
  2. One part bleach to ten parts water Correct answer.
  3. One part bleach to one hundred parts water
  4. Full-strength bleach poured on the surface

Explanation

A 1:10 dilution of household bleach, roughly 0.5% sodium hypochlorite, is the standard disinfectant for blood spills once visible material has been absorbed. The solution should be prepared fresh because it loses potency over time.

Question 13Safety and Compliance

A phlebotomist must collect blood from a patient on airborne precautions for suspected tuberculosis. What protection is required in addition to standard precautions?

  1. A fit-tested N95 respirator Correct answer.
  2. A face shield alone
  3. Shoe covers and a gown
  4. A standard surgical mask

Explanation

Airborne precautions require a fit-tested N95 or higher-level respirator, ideally with the patient placed in an airborne infection isolation room. A surgical mask does not seal to the face or filter small droplet nuclei.

Question 14Safety and Compliance

Employee medical records related to occupational blood exposure must be kept for at least:

  1. One year after the employee leaves
  2. The duration of employment plus 3 years
  3. The duration of employment plus 30 years Correct answer.
  4. Five years after the exposure

Explanation

Exposure and medical records must be kept confidential and retained for the duration of employment plus 30 years. Shorter retention periods do not satisfy the standard.

Question 15Safety and Compliance

At what frequency must bloodborne pathogens training be provided to employees with occupational exposure?

  1. Once, at initial assignment only
  2. Every two years
  3. At initial assignment, then annually Correct answer.
  4. Every six months

Explanation

Training is required when the employee is first assigned to tasks with exposure risk and at least annually thereafter, plus whenever new hazards or tasks are introduced.

Question 16Safety and Compliance

A patient becomes pale and sweaty and reports feeling faint during venipuncture. What should the phlebotomist do?

  1. Have the patient stand up to restore circulation
  2. Complete the draw quickly, then let the patient rest
  3. Give the patient a cold drink of water
  4. Stop the draw and lay the patient down Correct answer.

Explanation

The procedure is stopped, the needle withdrawn, and the patient placed supine with the legs elevated while vital signs are observed. Continuing the draw or having the patient stand risks a fall or loss of consciousness.

Question 17Safety and Compliance

Which of the following is an engineering control?

  1. A self-sheathing safety needle Correct answer.
  2. A written exposure control plan
  3. Annual bloodborne pathogens training
  4. A hepatitis B vaccination program

Explanation

Engineering controls physically isolate or remove the hazard from the worker, as with a self-sheathing needle or a sharps container. Training, written plans, and vaccination programs are administrative or medical measures.

Question 18Safety and Compliance

A phlebotomist may share a patient's laboratory results with:

  1. The patient's employer who requests them
  2. Any coworker who asks about the results
  3. A family member who telephones and asks
  4. Caregivers directly involved in the patient's care Correct answer.

Explanation

Protected health information may be disclosed only to caregivers involved in that patient's care, and only the minimum necessary. Employers, unrelated coworkers, and unverified telephone callers have no right to results.

Question 19Safety and Compliance

Which item belongs in a sharps container rather than a red biohazard bag?

  1. A used lancet Correct answer.
  2. Gloves contaminated with blood
  3. A blood-soaked disposable pad
  4. A blood-soaked gauze square

Explanation

Sharps containers receive needles, lancets, and other items capable of puncturing skin. Blood-soaked soft goods and contaminated gloves are soft waste and go into red biohazard bags.

Question 20Safety and Compliance

Which situation meets OSHA's definition of an occupational exposure?

  1. A phlebotomist handles a sealed, intact specimen container
  2. A phlebotomist walks past a patient who is coughing
  3. A phlebotomist eats lunch in the break room
  4. Blood from a leaking tube touches a cut on the hand Correct answer.

Explanation

Occupational exposure means contact with blood or other potentially infectious material through percutaneous injury, mucous membranes, or non-intact skin. Blood reaching a cut on the hand meets that definition.

Question 21Safety and Compliance

After a high-risk percutaneous exposure to blood from a patient whose HIV status is unknown, post-exposure management should begin:

  1. Promptly, ideally within hours of the exposure Correct answer.
  2. Only after the source patient's HIV test returns positive
  3. Within two weeks of the exposure
  4. Only if the employee develops symptoms

Explanation

HIV post-exposure prophylaxis is started as soon as possible, ideally within hours, because effectiveness declines as the interval lengthens. Treatment is not delayed while source testing is pending.

Question 22Safety and Compliance

Standard precautions are based on which principle?

  1. Isolation precautions replace hand hygiene
  2. Gloves are needed only when the chart lists a precaution
  3. All blood and body fluids are potentially infectious Correct answer.
  4. Only patients with diagnosed infections require protection

Explanation

Standard precautions treat all blood, body fluids, and moist body substances as potentially infectious regardless of diagnosis, so barriers are used for every patient encounter.

Question 23Safety and Compliance

Under OSHA, who is responsible for providing required personal protective equipment such as gloves and sharps containers?

  1. The laboratory supply vendor
  2. The employer, at no cost to the employee Correct answer.
  3. The employee, through a payroll deduction
  4. The patient's health insurance plan

Explanation

The employer must provide and pay for required personal protective equipment and engineering controls. Employees may not be charged for safety equipment needed to do their jobs.

Question 24Safety and Compliance

After an employee sustains a needlestick, what must the employer provide?

  1. Confidential follow-up at no cost Correct answer.
  2. Unpaid leave until test results return
  3. Requirement that the employee pay for baseline testing
  4. The employee's results sent to the supervisor

Explanation

The employer must make confidential medical evaluation and follow-up available at no cost, including testing and prophylaxis when indicated. Results are kept confidential and are not routed to supervisors.

Question 25Safety and Compliance

A phlebotomist is collecting blood from a patient with a known Clostridioides difficile infection. Which practice is required?

  1. Gloves only, with alcohol hand rub afterward
  2. Gown and gloves, then wash with soap and water Correct answer.
  3. A fit-tested N95 respirator
  4. No extra precautions beyond standard

Explanation

Contact precautions require a gown and gloves for all patient contact. Because C. difficile spores resist alcohol, hand washing with soap and water is preferred after the encounter.

Question 26Safety and Compliance

A phlebotomist removes gloves after a draw and sees visible blood on the hands. What is the appropriate hand hygiene action?

  1. Wash the hands with soap and running water Correct answer.
  2. Rub the hands with an alcohol-based hand rub until dry
  3. Wipe the hands with a dry paper towel and continue working
  4. Apply hand lotion after an alcohol-based hand rub

Explanation

Hands that are visibly contaminated with blood or body fluids must be washed with soap and running water. Alcohol-based hand rubs are intended for hands that are not visibly soiled. Washing should last at least 20 seconds and include all surfaces of the hands and wrists.

Question 27Safety and Compliance

Under OSHA's Bloodborne Pathogens standard, when must an employer offer hepatitis B vaccination to a newly hired employee with occupational exposure?

  1. Within 10 working days of initial assignment Correct answer.
  2. Within 24 hours of the first needlestick
  3. Within 30 calendar days of hire
  4. Only after the employee has had one exposure incident

Explanation

The hepatitis B vaccine must be offered within 10 working days of initial assignment to employees who have occupational exposure to blood or other potentially infectious materials. The offer is made before any exposure occurs and may be declined in writing. Vaccination is not delayed until an exposure incident happens.

Question 28Safety and Compliance

At what point should a sharps container be closed and replaced?

  1. Only at the end of each shift regardless of fill level
  2. When it is completely full and items no longer fit
  3. When it is one-quarter full
  4. When it is three-quarters full Correct answer.

Explanation

Sharps containers are replaced when they reach about three-quarters full, before items protrude or the container is overfilled. Overfilling increases the risk of needlesticks and spills during handling. A container is not kept in use simply because a shift has not ended.

Question 29Safety and Compliance

Blood splashes into a phlebotomist's eye during a draw. What should be done first?

  1. Wait to see whether irritation develops
  2. Irrigate the eye for at least 15 minutes Correct answer.
  3. Rub the eye with a clean gauze pad
  4. Apply antibiotic eye drops from the cabinet

Explanation

Mucous membrane exposure requires immediate flushing with water or saline for at least 15 minutes at an eyewash station or with a suitable irrigation device. The exposure should then be reported so post-exposure evaluation can begin. Rubbing the eye or delaying irrigation can increase the risk of infection.

Question 30Safety and Compliance

After completing a blood draw in a patient's room under contact precautions, in what order should the phlebotomist remove PPE?

  1. Gown first, then gloves, mask, and eye protection
  2. Gloves, eye protection, gown, then mask Correct answer.
  3. Eye protection, then mask, gown, and gloves
  4. Mask, gloves, gown, then eye protection

Explanation

PPE is removed in an order that minimizes contamination, generally starting with the most contaminated items. Gloves come off first, followed by eye protection and gown, with the mask or respirator removed last. Hand hygiene is performed after all PPE is removed.

Question 31Safety and Compliance

Where should a phlebotomist look for information about the hazards, handling, and spill cleanup of a disinfectant used in the collection area?

  1. The laboratory's annual budget report
  2. The manufacturer's social media page
  3. The Safety Data Sheet for the product Correct answer.
  4. The product's advertising brochure

Explanation

OSHA's Hazard Communication standard requires employers to maintain Safety Data Sheets that describe chemical hazards, safe handling, and spill response. The SDS is the standard reference available to employees in the workplace. Advertisements and informal sources are not reliable safety references.

Question 32Safety and Compliance

A patient tells the phlebotomist that wearing latex gloves causes itching and hives. What should the phlebotomist do?

  1. Use latex-free gloves and a latex-free tourniquet Correct answer.
  2. Double up with two pairs of latex gloves
  3. Ask the patient to hold the gauze over the puncture site
  4. Use the same gloves but remove them quickly

Explanation

A patient with a latex allergy must be protected from latex contact during the procedure. Latex-free gloves, tourniquet, and other supplies should be used, and the allergy should be documented. Doubling latex gloves or limiting contact time does not prevent an allergic reaction.

Question 33Safety and Compliance

A phlebotomist enters the room of a patient on contact precautions. Which action is correct?

  1. Wear a gown only and keep it on for the next patient
  2. Don gown and gloves on entry; remove before leaving Correct answer.
  3. Wear gloves only and remove them after leaving the room
  4. Wear a mask and eye protection but no gown or gloves

Explanation

Contact precautions require a gown and gloves for entry into the patient's room, with removal before leaving to avoid carrying organisms to other areas. Hand hygiene follows PPE removal. A gown is never reused for another patient.

Question 34Safety and Compliance

A tube of blood is being transported from a patient's room to the laboratory. How should it be carried?

  1. In the phlebotomist's uniform pocket
  2. In a paper envelope with the requisition
  3. In a leakproof secondary container Correct answer.
  4. Loose in a tray with other supplies

Explanation

Specimens must be transported in a leakproof secondary container so that a break or leak does not release blood into the environment. The primary tube is kept upright and secured within the secondary container. Carrying specimens loose or in an unsecured pocket increases the risk of exposure.

Question 35Safety and Compliance

When should a phlebotomist activate the safety feature on a blood collection needle?

  1. Immediately after the draw, before disposal Correct answer.
  2. At the end of the shift when all draws are complete
  3. Before inserting the needle into the vein
  4. Only if the patient has a known bloodborne infection

Explanation

The safety feature is activated immediately after the needle is withdrawn and before the device is disposed of. Activation is performed one-handed to keep the hands away from the point. Standard precautions require this for every patient, not only those with known infections.

Question 36Safety and Compliance

If a needle must be recapped, which method is acceptable?

  1. Recapping after laying the needle on the counter
  2. Asking the patient to hold the cap steady
  3. Using a one-handed scoop technique or a recapping device Correct answer.
  4. Holding the cap in one hand and guiding the needle with the other

Explanation

Recapping is discouraged, but when it is necessary it must be done with a mechanical device or a one-handed scoop technique. These methods keep the hand away from the needle point. Two-handed recapping is a common cause of needlestick injuries.

Question 37Safety and Compliance

What does the PASS acronym describe in fire safety?

  1. The process for documenting a needlestick
  2. The steps for using a fire extinguisher Correct answer.
  3. The steps for reporting a chemical spill
  4. The sequence for removing contaminated PPE

Explanation

PASS stands for Pull the pin, Aim at the base of the fire, Squeeze the handle, and Sweep from side to side. It is the standard sequence for operating a fire extinguisher on a small fire. Spill response, PPE removal, and exposure reporting use different procedures.

Question 38Safety and Compliance

A phlebotomist who has never received hepatitis B vaccine sustains a needlestick from a patient known to be HBsAg-positive. What post-exposure management is indicated?

  1. A single dose of HBIG only
  2. Begin the vaccine series alone and recheck titers later
  3. No treatment unless symptoms develop
  4. HBIG plus start the hepatitis B vaccine series Correct answer.

Explanation

An unvaccinated person exposed to an HBsAg-positive source needs both passive and active protection. Hepatitis B immune globulin provides immediate antibodies, and the vaccine series begins active immunity. Management should follow the exposure control plan and be started promptly after evaluation.

Question 39Safety and Compliance

Under OSHA recordkeeping rules, how quickly must an employer provide an employee with access to their medical records related to occupational exposure?

  1. Within 24 hours of the request
  2. Within 15 working days of the request Correct answer.
  3. Within 7 calendar days of the request
  4. Within 60 days of the request

Explanation

Employees are entitled to access their exposure-related medical records within 15 working days of a request. The employer may charge a reasonable cost for copying but cannot withhold the records. This access supports informed follow-up after an exposure incident.

Question 40Safety and Compliance

The Needlestick Safety and Prevention Act requires employers to do which of the following when selecting safer medical devices?

  1. Let the device manufacturer select the product
  2. Use only devices that have been on the market for five years
  3. Choose the lowest-priced device without staff input
  4. Solicit input from frontline nonmanagerial staff Correct answer.

Explanation

Employers must solicit and document input from nonmanagerial employees who have direct patient contact when evaluating and selecting safer medical devices. This frontline input helps ensure the chosen devices work in actual practice. Cost and manufacturer preference do not replace the required employee involvement.

Question 41Patient Preparation and Identification

Which pair of identifiers is acceptable for patient identification before venipuncture?

  1. Room number and bed number
  2. Insurance plan and home address
  3. Full name and date of birth Correct answer.
  4. Diagnosis and attending physician

Explanation

The two-identifier rule requires matching the patient using two independent pieces of information, most commonly full name and date of birth. Room, bed, diagnosis, and insurance details do not uniquely and reliably identify the patient.

Question 42Patient Preparation and Identification

Which of the following may be used as a patient identifier?

  1. The patient's room number
  2. The patient's bed location
  3. The medical record number Correct answer.
  4. The patient's physical appearance

Explanation

A medical record number is a unique identifier assigned to an individual patient and can serve as one of the two required identifiers. Location and appearance are not reliable or unique identifiers.

Question 43Patient Preparation and Identification

During a fasting blood collection, which item is permitted?

  1. Sugarless chewing gum
  2. Plain water Correct answer.
  3. Orange juice
  4. Black coffee

Explanation

Fasting generally means avoiding food and caloric beverages, but plain water is allowed and helps maintain hydration for venipuncture. Coffee, juice, and gum can affect test results or stimulate digestion.

Question 44Patient Preparation and Identification

What is the best way to verify the identity of an alert outpatient?

  1. Ask, 'Are you Mr. Smith?'
  2. Ask the receptionist
  3. Have the patient state full name and birth date Correct answer.
  4. Check the room assignment

Explanation

Having the patient state their full name and date of birth actively confirms identity and satisfies the two-identifier requirement. Yes-or-no confirmation is weaker because patients may agree out of confusion.

Question 45Patient Preparation and Identification

To limit hemoconcentration, a tourniquet should be released within:

  1. 3 minutes
  2. 10 minutes
  3. 1 minute Correct answer.
  4. 5 minutes

Explanation

The tourniquet should be released within 1 minute of application to reduce hemoconcentration and changes in analyte concentrations. Prolonged constriction pushes fluid out of the vessel and concentrates blood components.

Question 46Patient Preparation and Identification

A competent adult refuses a blood draw. The phlebotomist should:

  1. Obtain the specimen by capillary puncture
  2. Ask a coworker to restrain the patient
  3. Document the refusal and notify the supervisor Correct answer.
  4. Label a specimen from another patient

Explanation

A competent patient has the right to refuse a procedure, and the refusal must be documented and reported according to facility policy. The phlebotomist must not force, deceive, or mislabel specimens.

Question 47Patient Preparation and Identification

Before collecting blood from an inpatient, the phlebotomist must:

  1. Ask the roommate to confirm the name
  2. Check the name on the door
  3. Review the previous shift's notes
  4. Compare the ID band with the requisition Correct answer.

Explanation

The inpatient ID band is the primary source of identification and must be compared with the requisition before collection. Roommates, door signs, and old notes are not acceptable substitutes.

Question 48Patient Preparation and Identification

Blood cultures should ideally be collected:

  1. After antibiotics are started
  2. Before antibiotics are started Correct answer.
  3. Only when the fever peaks
  4. At the end of the shift

Explanation

Blood cultures are most likely to recover organisms when collected before antimicrobial therapy begins. Antibiotics can suppress bacterial growth and produce false-negative cultures.

Question 49Patient Preparation and Identification

An alert outpatient is scheduled for a chemistry panel. Which action best meets the two-identifier rule?

  1. Use the appointment time as the second identifier
  2. Confirm the patient's name only
  3. Have the patient state name and birth date Correct answer.
  4. Ask the patient to confirm the home address

Explanation

The two-identifier rule is met when the patient states two independent identifiers, such as full name and date of birth, and these are compared with the requisition. A single identifier or a non-unique detail is insufficient.

Question 50Patient Preparation and Identification

An unconscious patient has no ID band. The phlebotomist should:

  1. Draw the specimen and label it later
  2. Notify nursing staff and wait for identification Correct answer.
  3. Ask another patient in the room
  4. Use the patient's belongings to confirm identity

Explanation

When a patient cannot be identified, collection must wait until nursing staff apply or verify an ID band and identity is confirmed. Drawing first and labeling later creates an unacceptable risk of misidentification.