NCCT PHLEBOTOMY EXAM 2023/2024 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES|
ALREADY GRADED A
What is the first step in performing a venipuncture? -
CORRECT ANSWER identify the patient
RATIONALE
To prevent error and maintain a culture of safety, at least 2 identifiers (ex. full name and date of
birth) must be verified prior to performing a procedure.
What is the proper way to identify a patient prior to performing a venipuncture?
- CORRECT ANSWER Ask the patient to state his/her full name and DOB and compare to
the chart.
Before a venipuncture, the medical assistant should ask the patient to state his/her full name and
DOB (comparing what is stated to what is written in the chart or on a wrist band patient
identifier). This minimizes the risk for mis-identification errors because it cross-checks what the
patient says against written documentation. This provides a verified identity so that all tubes
collected will be associated with the correct patient (provided the medical assistant labels them
properly).
Using the guidelines for any method of venipuncture, what action should the medical assistant
perform directly after confirming patient identity? –
CORRECT ANSWER Review the requirements for collecting and handling the blood
specimen as ordered by the physician
To ensure accuracy and quality, it is important to anticipate your needs before beginning the
actual venipuncture (i.e. tube color/size, minimum acceptable blood volume, whether or not the
specimen needs to be placed on ice). Therefore, the medical assistant would identify the patient,
then review the requirements for collecting and handling the blood specimen as ordered by the
physician. Next, assemble the appropriate equipment and select the proper evacuated tubes for
test to be performed. Then, apply the tourniquet and thoroughly palpate the selected vein.
Finally, position the patient's arm and cleanse the site with an antiseptic wipe, then proceed with
the venipuncture protocol.
What should be avoided as a form of patient identification? –
CORRECT ANSWER insurance number
An insurance number is not a common means of positive patient identification (entire families
can share the same insurance policy number). Patients must be positively identified for medical
,services, whether they have insurance or not. Insurance information is necessary for billing
purposes. The only true unique identifier listed among these choices is the social security
number. Patient name and date of birth are also commonly used to confirm identification.
Name the two most used patient identifiers. -
CORRECT ANSWER Patient's name/date of birth
Name and DOB are most often used as positive patient identifiers as they are easily documented
and work for inpatients or outpatients. Bed numbers should never be used as identifiers for
inpatients or outpatients, nor should physician name associations. Medical record numbers are
valuable for inpatients, with name and DOB being used most often.
Prior to any type of inpatient specimen collection, a phlebotomist must correctly verify their
patient's identity by using which two-step procedure?
- CORRECT ANSWER Check ID bracelet, and ask patient to verbally confirm their identity.
The correct answer is to check the ID bracelet and ask the patient to verbally confirm his/her
identity. Patients may not have foot bed charts or IV bags, and the goal is to select the BEST
answer of all choices. If a patient has both an ID bracelet and can verify his/her own identity, it is
ideal.
The phlebotomist is drawing blood from a patient that is taking blood thinners. What is a
necessary piece of additional equipment to have at the drawing station?
- CORRECT ANSWER non-adhering bandage
RATIONALE
Non-adhering bandage material would be helpful for patients on anticoagulant therapy who may
bleed more extensively than typical patients after venipuncture. It is necessary to contain the
bleed with a bandage, but adhesive might bruise once removed from a patient who has
anticoagulated blood.
In which of the following time frames should a tourniquet be routinely released on a patient
while performing a blood draw?
- CORRECT ANSWER within one minute
RATIONALE
The standard time limit for having a tourniquet on a patient is one minute. Inaccurate laboratory
test results may occur if a tourniquet is not removed within one minute. When a tourniquet is
applied, the local blood flow is stopped. This leads to concentration of the blood and blood
entering the surrounding tissue. This may result in falsely high values for all protein-based
analytes, increased packed cell volume, and changes in other cellular elements. The most current
edition of the CLSI Procedures for the Collection of Diagnostic Blood Specimens by
, Venipuncture, H3-A6, states that the tourniquet application for preliminary vein selection should
not exceed one minute. For most patients, it is easy to release the tourniquet within the one-
minute period. Most veins are easily located and the venipuncture procedure can be completed
quickly.
A medical assistant has active symptoms of the common cold. Under which of the following
conditions may he perform venipuncture? -
CORRECT ANSWER The medical assistant may perform venipuncture provided he is
wearing a mask and afebrile.
RATIONALE
It is not uncommon for people to be able to work with the common cold. However, it is
important for medical personnel to use good judgment and not transmit diseases to their patients.
Medical personnel should take precautions and handle patient contact in a responsible manner.
They should not have patient contact if they are febrile, since that is when colds are highly
contagious. In this instance, the medical assistant may perform venipuncture provided he/she is
wearing a mask and afebrile. The medical assistant should wear the mask to keep from
transmitting the cold via coughing or sneezing on a patient.
What is an appropriate alternative to using a rubber tourniquet when attempting a venipuncture
on a known patient who is difficult to obtain a sample from? –
CORRECT ANSWER blood pressure cuff
RATIONALE
The only acceptable choice among the listed options is the blood pressure cuff. Occlusion
pressure may be adjusted as needed as an alternative to ensure circulation. In compliance with
CLSI (Clinical and Laboratory Standards Institute) standards, the blood pressure cuff can
provide uniform constriction, as long as the phlebotomist doesn't inflate the cuff beyond 40 mm
of mercury.
What evacuated tube should the medical assistant select for collection of electrolytes? -
CORRECT ANSWER green-top
RATIONALE
A green top tube contains heparin. Green tops are used for collection of heparinized plasma or
whole blood for special tests. Note: After the tube has been filled with blood, the tube is inverted
several times to prevent coagulation. Note: Green top tubes can contain ammonium, lithium, and
sodium in addition to the heparin. In this instance, lithium heparin would be the green-top of
choice (and sodium heparin would NOT be used for an electrolyte test). Electrolytes can also be
collected in a red-top tube.
What additive protects serum from interacting with red blood cells after a specimen has been
centrifuged? –
CORRECT DETAILED ANSWERS WITH RATIONALES|
ALREADY GRADED A
What is the first step in performing a venipuncture? -
CORRECT ANSWER identify the patient
RATIONALE
To prevent error and maintain a culture of safety, at least 2 identifiers (ex. full name and date of
birth) must be verified prior to performing a procedure.
What is the proper way to identify a patient prior to performing a venipuncture?
- CORRECT ANSWER Ask the patient to state his/her full name and DOB and compare to
the chart.
Before a venipuncture, the medical assistant should ask the patient to state his/her full name and
DOB (comparing what is stated to what is written in the chart or on a wrist band patient
identifier). This minimizes the risk for mis-identification errors because it cross-checks what the
patient says against written documentation. This provides a verified identity so that all tubes
collected will be associated with the correct patient (provided the medical assistant labels them
properly).
Using the guidelines for any method of venipuncture, what action should the medical assistant
perform directly after confirming patient identity? –
CORRECT ANSWER Review the requirements for collecting and handling the blood
specimen as ordered by the physician
To ensure accuracy and quality, it is important to anticipate your needs before beginning the
actual venipuncture (i.e. tube color/size, minimum acceptable blood volume, whether or not the
specimen needs to be placed on ice). Therefore, the medical assistant would identify the patient,
then review the requirements for collecting and handling the blood specimen as ordered by the
physician. Next, assemble the appropriate equipment and select the proper evacuated tubes for
test to be performed. Then, apply the tourniquet and thoroughly palpate the selected vein.
Finally, position the patient's arm and cleanse the site with an antiseptic wipe, then proceed with
the venipuncture protocol.
What should be avoided as a form of patient identification? –
CORRECT ANSWER insurance number
An insurance number is not a common means of positive patient identification (entire families
can share the same insurance policy number). Patients must be positively identified for medical
,services, whether they have insurance or not. Insurance information is necessary for billing
purposes. The only true unique identifier listed among these choices is the social security
number. Patient name and date of birth are also commonly used to confirm identification.
Name the two most used patient identifiers. -
CORRECT ANSWER Patient's name/date of birth
Name and DOB are most often used as positive patient identifiers as they are easily documented
and work for inpatients or outpatients. Bed numbers should never be used as identifiers for
inpatients or outpatients, nor should physician name associations. Medical record numbers are
valuable for inpatients, with name and DOB being used most often.
Prior to any type of inpatient specimen collection, a phlebotomist must correctly verify their
patient's identity by using which two-step procedure?
- CORRECT ANSWER Check ID bracelet, and ask patient to verbally confirm their identity.
The correct answer is to check the ID bracelet and ask the patient to verbally confirm his/her
identity. Patients may not have foot bed charts or IV bags, and the goal is to select the BEST
answer of all choices. If a patient has both an ID bracelet and can verify his/her own identity, it is
ideal.
The phlebotomist is drawing blood from a patient that is taking blood thinners. What is a
necessary piece of additional equipment to have at the drawing station?
- CORRECT ANSWER non-adhering bandage
RATIONALE
Non-adhering bandage material would be helpful for patients on anticoagulant therapy who may
bleed more extensively than typical patients after venipuncture. It is necessary to contain the
bleed with a bandage, but adhesive might bruise once removed from a patient who has
anticoagulated blood.
In which of the following time frames should a tourniquet be routinely released on a patient
while performing a blood draw?
- CORRECT ANSWER within one minute
RATIONALE
The standard time limit for having a tourniquet on a patient is one minute. Inaccurate laboratory
test results may occur if a tourniquet is not removed within one minute. When a tourniquet is
applied, the local blood flow is stopped. This leads to concentration of the blood and blood
entering the surrounding tissue. This may result in falsely high values for all protein-based
analytes, increased packed cell volume, and changes in other cellular elements. The most current
edition of the CLSI Procedures for the Collection of Diagnostic Blood Specimens by
, Venipuncture, H3-A6, states that the tourniquet application for preliminary vein selection should
not exceed one minute. For most patients, it is easy to release the tourniquet within the one-
minute period. Most veins are easily located and the venipuncture procedure can be completed
quickly.
A medical assistant has active symptoms of the common cold. Under which of the following
conditions may he perform venipuncture? -
CORRECT ANSWER The medical assistant may perform venipuncture provided he is
wearing a mask and afebrile.
RATIONALE
It is not uncommon for people to be able to work with the common cold. However, it is
important for medical personnel to use good judgment and not transmit diseases to their patients.
Medical personnel should take precautions and handle patient contact in a responsible manner.
They should not have patient contact if they are febrile, since that is when colds are highly
contagious. In this instance, the medical assistant may perform venipuncture provided he/she is
wearing a mask and afebrile. The medical assistant should wear the mask to keep from
transmitting the cold via coughing or sneezing on a patient.
What is an appropriate alternative to using a rubber tourniquet when attempting a venipuncture
on a known patient who is difficult to obtain a sample from? –
CORRECT ANSWER blood pressure cuff
RATIONALE
The only acceptable choice among the listed options is the blood pressure cuff. Occlusion
pressure may be adjusted as needed as an alternative to ensure circulation. In compliance with
CLSI (Clinical and Laboratory Standards Institute) standards, the blood pressure cuff can
provide uniform constriction, as long as the phlebotomist doesn't inflate the cuff beyond 40 mm
of mercury.
What evacuated tube should the medical assistant select for collection of electrolytes? -
CORRECT ANSWER green-top
RATIONALE
A green top tube contains heparin. Green tops are used for collection of heparinized plasma or
whole blood for special tests. Note: After the tube has been filled with blood, the tube is inverted
several times to prevent coagulation. Note: Green top tubes can contain ammonium, lithium, and
sodium in addition to the heparin. In this instance, lithium heparin would be the green-top of
choice (and sodium heparin would NOT be used for an electrolyte test). Electrolytes can also be
collected in a red-top tube.
What additive protects serum from interacting with red blood cells after a specimen has been
centrifuged? –
