Phlebotomy Practice Test

Phlebotomy Special Collections Practice Questions

Special Collections makes up 6 of every 50 questions on a Tigertest Phlebotomy practice test. Here are 10 of the 24 questions on it, each with the answer and the reason.

Updated 2026-11-10 by the Tigertest team. Weighted to the NHA CPT test plan. Order of draw and technique follow CLSI GP41 and GP42.

1. 1. Before drawing blood cultures from a patient with a suspected bloodstream infection, how should the venipuncture site be prepared?

   • A.Apply chlorhexidine and puncture while still wet
   • B.Chlorhexidine scrub 30 to 60 seconds, air dried
   • C.Wipe once with alcohol, then fan it dry
   • D.Wash it with soap and water only

   Answer: B. Blood culture sites need a friction scrub with chlorhexidine (or iodine) for 30 to 60 seconds and must air dry to kill skin flora. A quick alcohol wipe or touching the site leaves bacteria that contaminate cultures and falsely suggest infection.

2. 2. A phlebotomist removes the flip-off caps from a pair of blood culture bottles. What should be done to the rubber tops next?

   • A.Vent them first with a sterile needle
   • B.Nothing, because the caps kept them sterile
   • C.Coat them with iodine and leave it on
   • D.Wipe them with 70% isopropyl alcohol

   Answer: D. The tops under the caps are not guaranteed sterile, so they are cleaned with alcohol and allowed to dry before inoculation. Iodine left on the stopper can degrade the rubber and enter the bottle.

3. 3. Blood cultures are ordered on an adult patient. Which bottle is inoculated first with a butterfly set, and which with a syringe?

   • A.Aerobic with a butterfly; anaerobic with a syringe
   • B.Aerobic bottle first, regardless of the collection device
   • C.Anaerobic first with either collection device
   • D.Anaerobic with a butterfly; aerobic with a syringe

   Answer: A. Air in the butterfly tubing goes into the first bottle, so the aerobic bottle comes first with a butterfly. A syringe has no tubing air, so the anaerobic bottle is filled first to keep oxygen out of it.

4. 4. What blood volume per bottle is generally recommended when collecting blood cultures from an adult patient?

   • A.1 to 3 mL
   • B.0.5 mL
   • C.8 to 10 mL
   • D.20 to 30 mL

   Answer: C. Adult bottles usually need 8 to 10 mL each because detecting bacteria depends on volume, and underfilling is a common cause of missed infections. One to 3 mL is the pediatric range.

5. 5. A physician orders blood cultures for a febrile patient whose first IV antibiotic dose is due in 20 minutes. How should the cultures be collected?

   • A.One set, timed 1 hour after the antibiotic dose
   • B.One set drawn through the IV line after the antibiotic
   • C.Two sets from separate sites, before the antibiotic
   • D.Two sets from one site, after the antibiotic starts

   Answer: C. Two sets from separate venipuncture sites help tell true infection from skin contamination, and they are drawn before antibiotics, which can stop bacteria from growing in the bottles. Drawing after the dose risks false-negative cultures.

6. 6. A phlebotomist collects a newborn screening card from a heel puncture. How should the circles be filled and dried?

   • A.One drop per circle from one side, dried flat
   • B.Drops applied to both sides, then dried in a bag
   • C.Several small layered drops, then dried with heat
   • D.Paper pressed against the heel, then dried upright

   Answer: A. Each circle gets a single large drop applied to one side only until it soaks through, and the card dries horizontally at room temperature for at least 3 hours. Layering drops or filling from both sides gives uneven saturation and inaccurate results.

7. 7. A newborn screening specimen for PKU, galactosemia and hypothyroidism is ordered. When is it ideally collected?

   • A.Only after the infant is two weeks old
   • B.Immediately after delivery, using umbilical cord blood
   • C.Within the first 6 hours after birth
   • D.After 24 hours of age, once feeding has begun

   Answer: D. Screening is collected after 24 hours of age, usually by 48 hours, once the infant has had protein feedings; PKU can be missed if collected too early. Cord blood is unsuitable because the abnormal metabolites have not yet built up.

8. 8. A sick 2 kg premature infant needs daily blood work. About how much of the total blood volume may be drawn at one time?

   • A.About 10 to 15 percent
   • B.About 1 to 5 percent
   • C.About 20 to 25 percent
   • D.About one third

   Answer: B. Guidelines limit a single draw to roughly 1 to 5 percent of blood volume and about 10 percent over a month, because infants have little blood and can develop iatrogenic anemia. Each draw is recorded on a volume log.

9. 9. A phlebotomist is preparing to draw blood from an anxious 6-year-old with a parent present. Which approach is best?

   • A.Hide all of the equipment and say nothing at all
   • B.Explain honestly that it may hurt briefly
   • C.Warn that a shot will follow if they cry
   • D.Promise the child that it will not hurt

   Answer: B. Honest, simple explanations build trust, and a parent or helper can comfort and steady the child. Promising no pain destroys trust when the stick hurts, making later draws harder.

10. 10. An 88-year-old patient has thin skin and fragile veins that roll easily. Which adjustment is most appropriate?

    • A.A tighter tourniquet to make veins stand out
    • B.A 16 gauge needle to speed up the draw
    • C.Slapping the arm firmly to locate a vein
    • D.A looser tourniquet and a smaller needle

    Answer: D. Elderly veins are fragile and bruise or collapse easily, so a looser tourniquet and a 22 or 23 gauge needle or butterfly reduce trauma, with the vein well anchored. A tight tourniquet can tear skin and burst the vein.