NHA Phlebotomy Certification Exam Latest Update 2026
| Exam Prep | High-Yield Review Guide
1. Describe the role of sodium citrate in coagulation studies and why it is
preferred over other anticoagulants.
Sodium citrate enhances the activity of clotting factors in the blood.
Sodium citrate is used to stabilize blood samples for long-term
storage.
Sodium citrate promotes clotting by increasing calcium levels in the
blood.
Sodium citrate acts by binding calcium ions, which are necessary for
the coagulation process, thus preventing clot formation.
2. Describe the process by which plasma is obtained and how it differs from the
process of obtaining serum.
Plasma is obtained from a clotted sample, while serum is obtained
from a non-clotted sample.
Plasma is the liquid part of blood after clotting, while serum is the
solid part.
Plasma is obtained from a whole blood sample that has not clotted,
while serum is obtained from blood that has clotted and then been
centrifuged to remove the clot.
Plasma is obtained by heating blood, while serum is obtained by
cooling it.
3. Describe the significance of external liquid controls in point of care testing
for phlebotomists.
External liquid controls are only necessary for high-complexity tests.
, External liquid controls are primarily for training purposes.
External liquid controls are used to calibrate the testing equipment.
External liquid controls help verify that the testing process is
functioning correctly and that results are valid.
4. The phlebotomist recognizes that using evacuated tubes past their expiration
date may result in:
Hemoconcentration
Elevation of the red blood cell count
Hemolysis
Loss of vacuum
5. If a patient presents with symptoms of fatigue and weakness, which test
should be prioritized to evaluate for anemia?
blood culture
urinalysis
glucose test
complete blood count
6. Describe the rationale behind using implied consent for an unconscious
patient in a medical emergency.
Implied consent is used to avoid legal issues in all situations.
Implied consent requires a witness to validate the procedure.
Implied consent is used because it is assumed that the patient
would consent to treatment if they were able to do so.
Implied consent is only applicable in non-emergency situations.
,7. A phlebotomist is preparing to draw blood from a pt in a hospital. The pt
extends his arm and turns his head away. which of the following forms of
consent does this include?
implied consent
informed consent
expressed consent
refusal of consent
8. If a patient expresses discomfort with a clergy member present during a
blood draw, what should the phlebotomist do?
Continue with the blood draw while ignoring the patient's discomfort.
Request a supervisor to handle the situation.
Ask the patient to speak to the clergy member about their discomfort.
Politely ask the clergy member to leave the room to prioritize the
patient's comfort.
9. If a patient presents with a cloudy serum sample after fasting, what could be
a potential cause for this observation?
Increased bilirubin levels from liver dysfunction.
High lipid levels due to a metabolic disorder.
Hemolysis from improper sample handling.
Dehydration leading to concentrated serum.
10. If a phlebotomist experiences a needle stick injury while drawing blood from
a patient with a known infection, what additional steps should be taken after
flushing the area?
, Wait for symptoms to appear before taking action.
Only clean the area with alcohol wipes.
Report the incident and seek medical evaluation.
Continue working without interruption.
11. The phlebotomist asked a nurse to identify a patient without a wrist
identification band. The nurse said she did not have time. The next person in
the chain of command the phlebotomist should report to is the:
Patient's physician
Phlebotomy supervisor
Hospital administrator
Pathologist
12. What is the first action a phlebotomist should take when entering a patient's
room with a clergy member present?
Request the clergy member to assist with the blood draw.
Ask the clergy member to step outside during the procedure.
Inform the clergy member about the procedure.
Proceed with the blood draw without interruption.
13. Describe the importance of not overfilling a Sharps Container.
Overfilling is acceptable as long as the lid can close.
Overfilling does not affect the safety of the container.
Overfilling ensures that the container is used to its maximum capacity.
Overfilling a Sharps Container can lead to safety hazards and
improper disposal of sharps.
| Exam Prep | High-Yield Review Guide
1. Describe the role of sodium citrate in coagulation studies and why it is
preferred over other anticoagulants.
Sodium citrate enhances the activity of clotting factors in the blood.
Sodium citrate is used to stabilize blood samples for long-term
storage.
Sodium citrate promotes clotting by increasing calcium levels in the
blood.
Sodium citrate acts by binding calcium ions, which are necessary for
the coagulation process, thus preventing clot formation.
2. Describe the process by which plasma is obtained and how it differs from the
process of obtaining serum.
Plasma is obtained from a clotted sample, while serum is obtained
from a non-clotted sample.
Plasma is the liquid part of blood after clotting, while serum is the
solid part.
Plasma is obtained from a whole blood sample that has not clotted,
while serum is obtained from blood that has clotted and then been
centrifuged to remove the clot.
Plasma is obtained by heating blood, while serum is obtained by
cooling it.
3. Describe the significance of external liquid controls in point of care testing
for phlebotomists.
External liquid controls are only necessary for high-complexity tests.
, External liquid controls are primarily for training purposes.
External liquid controls are used to calibrate the testing equipment.
External liquid controls help verify that the testing process is
functioning correctly and that results are valid.
4. The phlebotomist recognizes that using evacuated tubes past their expiration
date may result in:
Hemoconcentration
Elevation of the red blood cell count
Hemolysis
Loss of vacuum
5. If a patient presents with symptoms of fatigue and weakness, which test
should be prioritized to evaluate for anemia?
blood culture
urinalysis
glucose test
complete blood count
6. Describe the rationale behind using implied consent for an unconscious
patient in a medical emergency.
Implied consent is used to avoid legal issues in all situations.
Implied consent requires a witness to validate the procedure.
Implied consent is used because it is assumed that the patient
would consent to treatment if they were able to do so.
Implied consent is only applicable in non-emergency situations.
,7. A phlebotomist is preparing to draw blood from a pt in a hospital. The pt
extends his arm and turns his head away. which of the following forms of
consent does this include?
implied consent
informed consent
expressed consent
refusal of consent
8. If a patient expresses discomfort with a clergy member present during a
blood draw, what should the phlebotomist do?
Continue with the blood draw while ignoring the patient's discomfort.
Request a supervisor to handle the situation.
Ask the patient to speak to the clergy member about their discomfort.
Politely ask the clergy member to leave the room to prioritize the
patient's comfort.
9. If a patient presents with a cloudy serum sample after fasting, what could be
a potential cause for this observation?
Increased bilirubin levels from liver dysfunction.
High lipid levels due to a metabolic disorder.
Hemolysis from improper sample handling.
Dehydration leading to concentrated serum.
10. If a phlebotomist experiences a needle stick injury while drawing blood from
a patient with a known infection, what additional steps should be taken after
flushing the area?
, Wait for symptoms to appear before taking action.
Only clean the area with alcohol wipes.
Report the incident and seek medical evaluation.
Continue working without interruption.
11. The phlebotomist asked a nurse to identify a patient without a wrist
identification band. The nurse said she did not have time. The next person in
the chain of command the phlebotomist should report to is the:
Patient's physician
Phlebotomy supervisor
Hospital administrator
Pathologist
12. What is the first action a phlebotomist should take when entering a patient's
room with a clergy member present?
Request the clergy member to assist with the blood draw.
Ask the clergy member to step outside during the procedure.
Inform the clergy member about the procedure.
Proceed with the blood draw without interruption.
13. Describe the importance of not overfilling a Sharps Container.
Overfilling is acceptable as long as the lid can close.
Overfilling does not affect the safety of the container.
Overfilling ensures that the container is used to its maximum capacity.
Overfilling a Sharps Container can lead to safety hazards and
improper disposal of sharps.
