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NHCO CERTIFIED PHLEBOTOMY TECHNICIAN
(CPT) ACTUAL EXAM PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED |NEW AND REVISED
1. The term "phlebotomy" is derived from Greek words that literally
mean:
A. Blood draw
B. Vein incision
C. Blood removal
D. Capillary puncture
Rationale: "Phlebo" refers to vein, and "tomy" means incision.
Therefore, phlebotomy literally means making an incision into a vein for
the purpose of collecting blood.
2. A phlebotomist's primary responsibility is to:
A. Diagnose medical conditions from blood samples
B. Obtain blood specimens through venipuncture or capillary
puncture techniques
C. Prescribe appropriate treatments based on laboratory results
D. Perform all laboratory testing from collected specimens
Rationale: The primary function of a phlebotomy technician is to collect
blood specimens from patients using various techniques for analysis and
diagnosis.
3. Which vein is the preferred site for routine venipuncture in an adult
due to its size and stability?
A. Basilic vein
B. Median cubital vein
,2|P a g e
C. Cephalic vein
D. Dorsal venous arch
Rationale: The median cubital vein is the first choice because it is large,
well-anchored, and less painful, with fewer underlying nerves.
4. A patient states, "I'm really nervous about needles. Every time I get
my blood drawn, I feel faint." Which of the following actions should the
phlebotomist take FIRST?
A. Proceed quickly without conversation to minimize anxiety
B. Ask the patient to lie down and assess for risk of syncope
C. Tell the patient to look away and hold their breath
D. Cancel the draw and refer the patient to an outpatient laboratory
Rationale: A reported history of fainting indicates a high risk of
syncope; the patient should be positioned supine or reclining during the
draw.
5. Which medical term describes the destruction of red blood cells that
can be caused by vigorous mixing or using a needle that is too small?
A. Hemostasis
B. Hemolysis
C. Hematoma
D. Hemoconcentration
Rationale: Hemolysis is the breakdown of RBCs, releasing hemoglobin
into the plasma and making the specimen unacceptable for many tests.
6. The phlebotomist is preparing to draw a patient with a "NPO after
midnight" order. This means the patient should:
A. Consume a clear liquid breakfast before the draw
B. Have nothing by mouth except water until after the draw
C. Take their morning medications with a small sip of water
D. Eat a high-protein meal to stabilize their blood sugar
Rationale: NPO (nil per os) means nothing by mouth; food or drink can
alter certain test results such as glucose and lipids.
,3|P a g e
7. The additive sodium citrate is found in which color blood collection
tube?
A. Red top
B. Light blue top
C. Green top
D. Lavender top
Rationale: Light-blue-top tubes contain sodium citrate, which binds
calcium to preserve coagulation factors for PT/INR and other
coagulation studies.
8. According to CLSI standards, what is the proper order of draw after
the blood culture bottles?
A. Red, Blue, Green, Lavender, Gray
B. Light Blue, Serum, Heparin, EDTA, Glycolytic Inhibitor
C. Lavender, Green, Blue, Red, Gray
D. Gray, Lavender, Green, Red, Blue
Rationale: The CLSI order is: Blood Culture → Light Blue (citrate) →
Serum (red/speckled/gold) → Heparin (green) → EDTA (lavender) →
Glycolytic (gray).
9. A patient is suspected of having a bloodstream infection. Which
specimen should be collected FIRST?
A. Light blue tube for coagulation studies
B. Blood culture bottles
C. Lavender tube for CBC
D. Green tube for chemistry panels
Rationale: Blood cultures are collected first to minimize the risk of
contamination from the venipuncture site or additives from other tubes.
10. The phlebotomist has a requisition for a complete blood count
(CBC). Which tube MUST be used?
A. Light blue top
B. Green top (heparin)
C. Lavender top (EDTA)
, 4|P a g e
D. Gray top (sodium fluoride)
Rationale: CBC requires whole blood preserved with EDTA to prevent
clotting and preserve cellular morphology.
11. A patient presents for a glucose tolerance test (GTT). After the
baseline draw, the patient drinks the glucose load and vomits 15 minutes
later. The phlebotomist should:
A. Immediately draw the 1-hour specimen and document the vomiting
B. Notify the provider; the test should be rescheduled
C. Continue with the test and note that results may be altered
D. Repeat the glucose load without delay
Rationale: Vomiting means the glucose load was not fully absorbed;
continuing the test yields invalid results.
12. Which of the following is a patient identifier that must be verified
according to The Joint Commission's National Patient Safety Goals?
A. Room number
B. Date of birth
C. Bed location
D. Physician's name
Rationale: Two identifiers (name, date of birth, medical record number)
are required, but not room or bed numbers, as these change.
13. A phlebotomist notices the patient's arm appears pale with a bluish
discoloration after tourniquet application for 90 seconds. The likely
cause is:
A. Hemoconcentration
B. Petechiae formation
C. Venous stasis
D. Arterial puncture
Rationale: Tourniquets left on too long cause stagnation of blood flow
and changes in blood composition.
14. Which additive is responsible for preventing glycolysis in blood
specimens?
NHCO CERTIFIED PHLEBOTOMY TECHNICIAN
(CPT) ACTUAL EXAM PREP 2026 ALL
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED |NEW AND REVISED
1. The term "phlebotomy" is derived from Greek words that literally
mean:
A. Blood draw
B. Vein incision
C. Blood removal
D. Capillary puncture
Rationale: "Phlebo" refers to vein, and "tomy" means incision.
Therefore, phlebotomy literally means making an incision into a vein for
the purpose of collecting blood.
2. A phlebotomist's primary responsibility is to:
A. Diagnose medical conditions from blood samples
B. Obtain blood specimens through venipuncture or capillary
puncture techniques
C. Prescribe appropriate treatments based on laboratory results
D. Perform all laboratory testing from collected specimens
Rationale: The primary function of a phlebotomy technician is to collect
blood specimens from patients using various techniques for analysis and
diagnosis.
3. Which vein is the preferred site for routine venipuncture in an adult
due to its size and stability?
A. Basilic vein
B. Median cubital vein
,2|P a g e
C. Cephalic vein
D. Dorsal venous arch
Rationale: The median cubital vein is the first choice because it is large,
well-anchored, and less painful, with fewer underlying nerves.
4. A patient states, "I'm really nervous about needles. Every time I get
my blood drawn, I feel faint." Which of the following actions should the
phlebotomist take FIRST?
A. Proceed quickly without conversation to minimize anxiety
B. Ask the patient to lie down and assess for risk of syncope
C. Tell the patient to look away and hold their breath
D. Cancel the draw and refer the patient to an outpatient laboratory
Rationale: A reported history of fainting indicates a high risk of
syncope; the patient should be positioned supine or reclining during the
draw.
5. Which medical term describes the destruction of red blood cells that
can be caused by vigorous mixing or using a needle that is too small?
A. Hemostasis
B. Hemolysis
C. Hematoma
D. Hemoconcentration
Rationale: Hemolysis is the breakdown of RBCs, releasing hemoglobin
into the plasma and making the specimen unacceptable for many tests.
6. The phlebotomist is preparing to draw a patient with a "NPO after
midnight" order. This means the patient should:
A. Consume a clear liquid breakfast before the draw
B. Have nothing by mouth except water until after the draw
C. Take their morning medications with a small sip of water
D. Eat a high-protein meal to stabilize their blood sugar
Rationale: NPO (nil per os) means nothing by mouth; food or drink can
alter certain test results such as glucose and lipids.
,3|P a g e
7. The additive sodium citrate is found in which color blood collection
tube?
A. Red top
B. Light blue top
C. Green top
D. Lavender top
Rationale: Light-blue-top tubes contain sodium citrate, which binds
calcium to preserve coagulation factors for PT/INR and other
coagulation studies.
8. According to CLSI standards, what is the proper order of draw after
the blood culture bottles?
A. Red, Blue, Green, Lavender, Gray
B. Light Blue, Serum, Heparin, EDTA, Glycolytic Inhibitor
C. Lavender, Green, Blue, Red, Gray
D. Gray, Lavender, Green, Red, Blue
Rationale: The CLSI order is: Blood Culture → Light Blue (citrate) →
Serum (red/speckled/gold) → Heparin (green) → EDTA (lavender) →
Glycolytic (gray).
9. A patient is suspected of having a bloodstream infection. Which
specimen should be collected FIRST?
A. Light blue tube for coagulation studies
B. Blood culture bottles
C. Lavender tube for CBC
D. Green tube for chemistry panels
Rationale: Blood cultures are collected first to minimize the risk of
contamination from the venipuncture site or additives from other tubes.
10. The phlebotomist has a requisition for a complete blood count
(CBC). Which tube MUST be used?
A. Light blue top
B. Green top (heparin)
C. Lavender top (EDTA)
, 4|P a g e
D. Gray top (sodium fluoride)
Rationale: CBC requires whole blood preserved with EDTA to prevent
clotting and preserve cellular morphology.
11. A patient presents for a glucose tolerance test (GTT). After the
baseline draw, the patient drinks the glucose load and vomits 15 minutes
later. The phlebotomist should:
A. Immediately draw the 1-hour specimen and document the vomiting
B. Notify the provider; the test should be rescheduled
C. Continue with the test and note that results may be altered
D. Repeat the glucose load without delay
Rationale: Vomiting means the glucose load was not fully absorbed;
continuing the test yields invalid results.
12. Which of the following is a patient identifier that must be verified
according to The Joint Commission's National Patient Safety Goals?
A. Room number
B. Date of birth
C. Bed location
D. Physician's name
Rationale: Two identifiers (name, date of birth, medical record number)
are required, but not room or bed numbers, as these change.
13. A phlebotomist notices the patient's arm appears pale with a bluish
discoloration after tourniquet application for 90 seconds. The likely
cause is:
A. Hemoconcentration
B. Petechiae formation
C. Venous stasis
D. Arterial puncture
Rationale: Tourniquets left on too long cause stagnation of blood flow
and changes in blood composition.
14. Which additive is responsible for preventing glycolysis in blood
specimens?
