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NHA Phlebotomy Certification Exam 2025–2026 | 120
Practice Questions with Correct Answers & Rationales
1. What is the correct basic order of draw for routine venipuncture (after blood culture bottles)?
A. Lavender, green, light blue, red
B. Light blue, red/SST, green, lavender, gray
C. Red/SST, light blue, green, lavender, gray
D. Green, light blue, red, lavender, gray
Correct: B
Rationale: Standard venipuncture order (after sterile blood culture bottles) is: light blue (citrate
for coagulation) → red or serum separator (SST) → green (heparin) → lavender (EDTA) → gray
(fluoride/oxalate). Following the order prevents cross-contamination of additives.
2. How should a semen specimen for fertility testing be stored/transported?
A. Refrigerated at 2–8°C
B. Kept at 36–38°C and transported promptly
C. Frozen immediately
D. Room temperature (20–25°C) is fine
Correct: B
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Rationale: Semen samples must be kept near body temperature (about 36–38°C) and transported
quickly to the lab to preserve motility and validity of testing.
3. A specimen for ammonia level is collected. What must be done immediately?
A. Put on ice and transport chilled to the lab
B. Allow to clot at room temperature then spin
C. Protect from light only
D. Freeze the sample at −20°C immediately
Correct: A
Rationale: Ammonia is unstable; draw into a prechilled tube if possible, place on ice
immediately, and transport on ice to minimize false elevations.
4. Which of the following is a common cause of a grossly hemolyzed specimen?
A. Using too large a needle gauge (e.g., 16G)
B. Using a needle that’s too small (high gauge) or excessive force during draw
C. Labeling the tube incorrectly
D. Centrifuging at the correct speed
Correct: B
Rationale: Hemolysis often results from excessive shear stress: using too small a needle (too
high a gauge for the draw), drawing through a syringe with excessive force, vigorous shaking, or
prolonged tourniquet time.
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5. What is the preferred vein for routine venipuncture in the antecubital fossa?
A. Basilic vein first choice
B. Cephalic vein first choice
C. Median cubital vein first choice
D. Dorsal hand veins first choice
Correct: C
Rationale: The median cubital vein is usually well anchored, less likely to roll, and safest for
venipuncture; basilic is deeper and near nerves/arteries.
6. For blood culture collection, which skin antiseptic is preferred and what is critical about its
use?
A. Alcohol only — wipe and immediately draw
B. Povidone-iodine — scrub, then draw while wet
C. Chlorhexidine with alcohol — scrub and allow to dry completely before collection
D. Soapy water — sufficient if patient is dirty
Correct: C
Rationale: Chlorhexidine in alcohol provides superior antisepsis. It must be allowed to dry
completely to maximize antimicrobial effect and avoid contamination.
7. When should phlebotomy specimens be labeled?
A. Label at the bench after walking away from the patient
B. Label in presence of the patient immediately after collection — include name, DOB,
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date/time, collector ID
C. Label only when delivering to the lab
D. Handwritten label on a sticky note is fine later
Correct: B
Rationale: Labeling at the bedside in the patient’s presence prevents misidentification. Include
patient identifiers, date/time of collection, and collector initials or ID.
8. What is the recommended maximum tourniquet time to avoid hemoconcentration and
inaccurate results?
A. 5 minutes
B. 4 minutes
C. 1 minute (ideally under 1 minute)
D. 10 minutes
Correct: C
Rationale: Keep tourniquet time under 1 minute whenever possible. Prolonged application (>1
minute) can cause hemoconcentration and alter test results.
9. For heel sticks on newborns, the best puncture site is:
A. The center of the heel (plantar medial)
B. The lateral or medial plantar surface of the heel (avoid the central area)
C. The arch of the foot near the toes
D. Dorsum of the foot near the ankle
NHA Phlebotomy Certification Exam 2025–2026 | 120
Practice Questions with Correct Answers & Rationales
1. What is the correct basic order of draw for routine venipuncture (after blood culture bottles)?
A. Lavender, green, light blue, red
B. Light blue, red/SST, green, lavender, gray
C. Red/SST, light blue, green, lavender, gray
D. Green, light blue, red, lavender, gray
Correct: B
Rationale: Standard venipuncture order (after sterile blood culture bottles) is: light blue (citrate
for coagulation) → red or serum separator (SST) → green (heparin) → lavender (EDTA) → gray
(fluoride/oxalate). Following the order prevents cross-contamination of additives.
2. How should a semen specimen for fertility testing be stored/transported?
A. Refrigerated at 2–8°C
B. Kept at 36–38°C and transported promptly
C. Frozen immediately
D. Room temperature (20–25°C) is fine
Correct: B
,2
Rationale: Semen samples must be kept near body temperature (about 36–38°C) and transported
quickly to the lab to preserve motility and validity of testing.
3. A specimen for ammonia level is collected. What must be done immediately?
A. Put on ice and transport chilled to the lab
B. Allow to clot at room temperature then spin
C. Protect from light only
D. Freeze the sample at −20°C immediately
Correct: A
Rationale: Ammonia is unstable; draw into a prechilled tube if possible, place on ice
immediately, and transport on ice to minimize false elevations.
4. Which of the following is a common cause of a grossly hemolyzed specimen?
A. Using too large a needle gauge (e.g., 16G)
B. Using a needle that’s too small (high gauge) or excessive force during draw
C. Labeling the tube incorrectly
D. Centrifuging at the correct speed
Correct: B
Rationale: Hemolysis often results from excessive shear stress: using too small a needle (too
high a gauge for the draw), drawing through a syringe with excessive force, vigorous shaking, or
prolonged tourniquet time.
,3
5. What is the preferred vein for routine venipuncture in the antecubital fossa?
A. Basilic vein first choice
B. Cephalic vein first choice
C. Median cubital vein first choice
D. Dorsal hand veins first choice
Correct: C
Rationale: The median cubital vein is usually well anchored, less likely to roll, and safest for
venipuncture; basilic is deeper and near nerves/arteries.
6. For blood culture collection, which skin antiseptic is preferred and what is critical about its
use?
A. Alcohol only — wipe and immediately draw
B. Povidone-iodine — scrub, then draw while wet
C. Chlorhexidine with alcohol — scrub and allow to dry completely before collection
D. Soapy water — sufficient if patient is dirty
Correct: C
Rationale: Chlorhexidine in alcohol provides superior antisepsis. It must be allowed to dry
completely to maximize antimicrobial effect and avoid contamination.
7. When should phlebotomy specimens be labeled?
A. Label at the bench after walking away from the patient
B. Label in presence of the patient immediately after collection — include name, DOB,
, 4
date/time, collector ID
C. Label only when delivering to the lab
D. Handwritten label on a sticky note is fine later
Correct: B
Rationale: Labeling at the bedside in the patient’s presence prevents misidentification. Include
patient identifiers, date/time of collection, and collector initials or ID.
8. What is the recommended maximum tourniquet time to avoid hemoconcentration and
inaccurate results?
A. 5 minutes
B. 4 minutes
C. 1 minute (ideally under 1 minute)
D. 10 minutes
Correct: C
Rationale: Keep tourniquet time under 1 minute whenever possible. Prolonged application (>1
minute) can cause hemoconcentration and alter test results.
9. For heel sticks on newborns, the best puncture site is:
A. The center of the heel (plantar medial)
B. The lateral or medial plantar surface of the heel (avoid the central area)
C. The arch of the foot near the toes
D. Dorsum of the foot near the ankle
