Phlebotomy Patient Preparation Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Easy

   Which setup is safest for an outpatient venipuncture?

   1. AA. Seated on a rolling stool beside the counter
   2. BB. Standing, with the arm resting on a counter
   3. CC. Seated in a drawing chair with an arm support
   4. DD. Seated on a chair that has no arms or support
   Show answer to question 1

   Answer: C. Seated in a drawing chair with an arm support

   A phlebotomy drawing chair with an adjustable arm support steadies the arm and helps keep the patient from falling if fainting occurs. Patients are never drawn while standing or sitting on a stool.

   Why the other options are wrong

   • AA stool has no back or arm support, so a patient who faints can fall.
   • BA standing patient who faints can fall and be seriously injured.
   • DA chair without arms gives no support to the arm and no protection against a fall.

2. Question 2 of 25Easy

   Which request is an example of a timed collection?

   1. AA. A glucose drawn at once for a patient who suddenly became confused
   2. BB. Serial troponin levels drawn at set intervals after admission
   3. CC. A complete blood count added to tomorrow's routine morning list
   4. DD. An electrolyte panel to be collected as soon as possible this shift
   Show answer to question 2

   Answer: B. Serial troponin levels drawn at set intervals after admission

   Timed requests are collected at specific times so results can be compared over time, as with serial cardiac markers and tolerance tests. Accurate timing is essential to interpret them.

   Why the other options are wrong

   • AAn immediate draw for a sudden change in condition is a STAT request.
   • CA test added to the routine morning list has routine priority.
   • DA request to collect as soon as possible during the shift is an ASAP priority.

3. Question 3 of 25Hard

   When a person moves from lying down to standing, fluid shifts out of the blood vessels into the tissues. How does this affect blood test results?

   1. AA. Cells and proteins become slightly more concentrated
   2. BB. Cells and proteins become slightly more diluted
   3. CC. Only the blood glucose concentration rises noticeably
   4. DD. Results stay the same, since no blood leaves the body
   Show answer to question 3

   Answer: A. Cells and proteins become slightly more concentrated

   When plasma water moves into the tissues, cells and large molecules such as proteins, and substances bound to them, become more concentrated. Because posture affects results, some tests specify the patient's position or rest time before collection.

   Why the other options are wrong

   • BFluid leaves the blood on standing, so the blood becomes more concentrated, not diluted.
   • CThe shift mainly affects cells and large molecules; small molecules such as glucose move freely and change little.
   • DThe volume of plasma in the vessels changes with posture even though no blood leaves the body.

4. Question 4 of 25Hard

   During the pre-draw interview at an outpatient draw station, which statement from a 38-year-old woman should change how the phlebotomist sets up the draw?

   1. AA. I drank a glass of water this morning.
   2. BB. I fainted the last time I had blood drawn.
   3. CC. I would rather not watch the needle go in.
   4. DD. My left arm is usually easier to draw from.
   Show answer to question 4

   Answer: B. I fainted the last time I had blood drawn.

   A history of fainting during blood draws means the patient should lie down for the procedure, which prevents a fall and injury if she faints again. The phlebotomist arranges this before starting.

   Why the other options are wrong

   • AWater is generally allowed and does not change the setup.
   • CLooking away during the draw is fine and does not require a different setup.
   • DA preferred arm can be considered, but it does not change the safety setup.

5. Question 5 of 25Easy

   Which pair of identifiers is acceptable for confirming a hospital inpatient's identity before a blood draw?

   1. AA. Full name and date of birth
   2. BB. Full name and room number
   3. CC. Date of birth and diagnosis
   4. DD. Full name and attending physician
   Show answer to question 5

   Answer: A. Full name and date of birth

   At least two person-specific identifiers, such as full name and date of birth or medical record number, are compared on the ID band and the requisition. The patient states them when able.

   Why the other options are wrong

   • BA room number is never an identifier, because patients change rooms and beds.
   • CA diagnosis is shared by many patients and is not a person-specific identifier.
   • DMany patients share the same attending physician, so it does not identify one person.

6. Question 6 of 25Hard

   A 78-year-old man in a long-term care facility tells the phlebotomist that adhesive bandages make his thin skin red and itchy. Which plan for the end of the draw is best?

   1. AA. Apply an adhesive bandage and remove it in 5 minutes
   2. BB. Skip pressure and leave the site open to the air
   3. CC. Cover the site with cloth adhesive tape instead
   4. DD. Hold pressure, then use gauze and self-adherent wrap
   Show answer to question 6

   Answer: D. Hold pressure, then use gauze and self-adherent wrap

   For a patient who reacts to adhesive, the phlebotomist holds pressure until bleeding stops, then secures gauze with self-adherent wrap, which sticks to itself rather than to skin, applied snugly but not tightly. This avoids irritation and skin tears.

   Why the other options are wrong

   • AEven brief contact with adhesive can cause a reaction in a sensitive patient.
   • BPressure is still needed to stop bleeding and prevent a hematoma.
   • CCloth adhesive tape contains adhesive and can irritate or tear his fragile skin.

7. Question 7 of 25Easy

   In therapeutic drug monitoring, when is a trough level collected?

   1. AA. Just before the next scheduled dose
   2. BB. Right after the dose is finished
   3. CC. Halfway between two scheduled doses
   4. DD. When the drug reaches its highest level
   Show answer to question 7

   Answer: A. Just before the next scheduled dose

   A trough is the lowest drug concentration, which occurs just before the next dose is given. The phlebotomist coordinates the draw with the nurse and records the exact collection time.

   Why the other options are wrong

   • BRight after a dose, the level is high or still rising toward its peak, not at its lowest point.
   • CA midpoint draw reflects neither the lowest nor the highest level and does not match a trough order.
   • DThe highest level is the peak, which is a different timed specimen.

8. Question 8 of 25Hard

   A mobile phlebotomist has a timed draw ordered for 1400 at a patient's home but, because of traffic, collects it at 1425. Which collection time should be documented?

   1. AA. 1425, the actual time the specimen was collected
   2. BB. 1400, with a separate note that the draw was 25 minutes late
   3. CC. 1400, since that is the time the provider ordered on the requisition
   4. DD. The arrival time at the home, since that is when the visit began
   Show answer to question 8

   Answer: A. 1425, the actual time the specimen was collected

   Documentation must show the actual collection time, because timed results are interpreted against it. Integrity means recording what happened and reporting the delay as policy requires.

   Why the other options are wrong

   • BThe collection time must be the actual time; a side note does not make a false entry accurate.
   • CRecording the ordered time instead of the actual time is false documentation and can mislead result interpretation.
   • DArrival time is not collection time, and timed results depend on when the blood was drawn.

9. Question 9 of 25Medium

   During a home draw, a 64-year-old man who receives hemodialysis mentions a fistula in his left forearm. Which plan is correct?

   1. AA. Draw from the fistula, since its blood flow is strong
   2. BB. Use the left antecubital area, well above the fistula
   3. CC. Put the tourniquet on the left arm and draw from the hand
   4. DD. Use the right arm and keep any tourniquet off the left
   Show answer to question 9

   Answer: D. Use the right arm and keep any tourniquet off the left

   An arm with an arteriovenous fistula or graft is never used for venipuncture, a tourniquet or a blood pressure cuff, because pressure or puncture can damage the access he needs for dialysis. The other arm is used.

   Why the other options are wrong

   • AOnly trained dialysis staff access a fistula, and puncturing it risks damage, infection and bleeding.
   • BAny tourniquet or puncture on that arm can harm the fistula.
   • CA tourniquet on the fistula arm can compress and damage the access.

10. Question 10 of 25Hard

    During registration at an outpatient draw site, a woman gives her name as "Liz Carter." Her photo ID and insurance card both read "Elizabeth Ann Carter." How should her name be entered in the record?

    1. AA. As Liz Carter, since that is the name she gave at the front desk
    2. BB. As Elizabeth Ann Carter, matching her photo ID and insurance card
    3. CC. As E. Carter, so that either version of her name will match later
    4. DD. As Liz Carter, with her legal name written only on the requisition
    Show answer to question 10

    Answer: B. As Elizabeth Ann Carter, matching her photo ID and insurance card

    The record should use the legal name exactly as it appears on the photo ID and insurance card, so identifiers on labels, results and claims match. A preferred name can be noted where the system allows.

    Why the other options are wrong

    • AA nickname in the legal name field will not match her ID or insurance and can cause identification and billing errors.
    • CAn initial is incomplete and raises the chance of confusing her with other patients.
    • DDifferent names on the record and requisition create a mismatch that could stop the collection or misroute results.

11. Question 11 of 25Easy

    Why should the phlebotomist avoid a venipuncture site with edema (swelling)?

    1. AA. Tissue fluid can contaminate the specimen
    2. BB. Swollen tissue makes blood clot faster
    3. CC. Edema raises the risk of hitting an artery
    4. DD. A tourniquet cannot be placed over swelling
    Show answer to question 11

    Answer: A. Tissue fluid can contaminate the specimen

    Excess tissue fluid in a swollen area can dilute or contaminate the specimen and alter results. Veins there are also hard to find and palpate, and the tissue may heal poorly.

    Why the other options are wrong

    • BEdema does not make blood clot faster.
    • CThe concern with edema is fluid contamination and hidden veins, not arterial puncture.
    • DA tourniquet can be applied, but the swollen site is still unsuitable for collection.

12. Question 12 of 25Medium

    A 45-year-old man in the hospital has casts on both arms after a motorcycle crash. The phlebotomist considers a vein on the top of his foot. Before using this site, what must the phlebotomist obtain?

    1. AA. Permission from the patient's provider
    2. BB. A signed form from a family member
    3. CC. Verbal agreement from the patient alone
    4. DD. Approval from another phlebotomist on shift
    Show answer to question 12

    Answer: A. Permission from the patient's provider

    Leg, ankle and foot veins carry a higher risk of complications such as clots and infection, so CLSI guidance and facility policies call for the provider's permission before they are used. These sites are generally avoided in patients with diabetes or poor circulation.

    Why the other options are wrong

    • BA family member's signature does not authorize a lower-extremity venipuncture site.
    • CThe patient's agreement is needed but does not replace the provider's permission.
    • DAnother phlebotomist cannot authorize a site that requires provider approval.

13. Question 13 of 25Medium

    When explaining a venipuncture, which instruction to the patient is most important for safety?

    1. AA. Pump your fist hard during the whole draw.
    2. BB. Tell me at once if you feel faint or sharp pain.
    3. CC. Bend your elbow up as soon as the needle is in.
    4. DD. Hold your breath until all the tubes are filled.
    Show answer to question 13

    Answer: B. Tell me at once if you feel faint or sharp pain.

    Asking the patient to report lightheadedness or sharp, shooting or electric pain right away lets the phlebotomist stop the draw before a fall or nerve injury. This instruction is a key part of preparing the patient.

    Why the other options are wrong

    • AVigorous fist pumping can falsely raise some results, such as potassium, and is not recommended.
    • CBending the arm while the needle is in can dislodge it and cause a hematoma.
    • DHolding the breath can make a patient lightheaded and is not part of the procedure.

14. Question 14 of 25Medium

    While palpating the arm of a 68-year-old man with a history of many hospital stays, the phlebotomist finds a vein that feels hard and cord-like and does not bounce back. What should the phlebotomist do?

    1. AA. Use it, since a firm vein will not roll
    2. BB. Use it with a bigger needle to pass through
    3. CC. Tighten the tourniquet and wait for it to soften
    4. DD. Choose another vein that feels soft and bouncy
    Show answer to question 14

    Answer: D. Choose another vein that feels soft and bouncy

    A hard, cord-like vein that lacks resilience is likely sclerosed or thrombosed from repeated punctures or inflammation. Such veins are hard to enter and may not yield blood, so a resilient vein is chosen instead.

    Why the other options are wrong

    • AFirmness here signals a damaged vein, not a well-anchored one.
    • BA bigger needle does not restore flow through a scarred or blocked vein.
    • CA tighter tourniquet does not soften a sclerosed vein and can cause hemoconcentration.

15. Question 15 of 25Medium

    A phlebotomist arrives for a routine draw on a 57-year-old inpatient who is not wearing an ID band. A band with his information is lying on the bedside table. What should the phlebotomist do?

    1. AA. Attach the band to the patient's wrist and proceed with the draw
    2. BB. Use the band on the table, since it shows the correct information
    3. CC. Ask the patient's nurse to place an ID band on him before collecting
    4. DD. Confirm the room number with the patient and proceed with the draw
    Show answer to question 15

    Answer: C. Ask the patient's nurse to place an ID band on him before collecting

    An inpatient must wear an attached ID band before collection. The nurse or other authorized staff, per facility policy, verifies identity and attaches the band, and then the phlebotomist identifies the patient as usual.

    Why the other options are wrong

    • APhlebotomists generally do not attach ID bands; authorized staff verify identity and apply them.
    • BA band that is not attached to the patient could belong to someone else and cannot be used.
    • DA room number is never an acceptable identifier.

16. Question 16 of 25Medium

    When a medical interpreter is assisting during a blood draw, how should the phlebotomist communicate?

    1. AA. Face the interpreter throughout, since the interpreter relays it all
    2. BB. Speak to the interpreter, saying "Ask the patient for a birth date"
    3. CC. Speak directly to the patient in short phrases and pause often
    4. DD. Have a family member repeat the answers to the interpreter as well
    Show answer to question 16

    Answer: C. Speak directly to the patient in short phrases and pause often

    The phlebotomist faces and speaks directly to the patient in short statements, pausing so the interpreter can relay each one accurately.

    Why the other options are wrong

    • AWatching the interpreter instead of the patient misses nonverbal cues and feels impersonal.
    • BSpeaking about the patient in the third person shuts the patient out; questions go directly to the patient.
    • DAdding a family member as a go-between lowers accuracy and privacy.

17. Question 17 of 25Medium

    A 45-year-old man with a severe intellectual disability arrives from his group home with a staff member for an outpatient draw. His record shows that a court has appointed his sister as his legal guardian. Whose permission is required?

    1. AA. The group home staff member who brought him to the visit
    2. BB. The patient's own verbal agreement, since he is an adult
    3. CC. The ordering provider, since the order itself implies consent
    4. DD. His sister, as legal guardian, while it is still explained to him
    Show answer to question 17

    Answer: D. His sister, as legal guardian, while it is still explained to him

    When a court has appointed a legal guardian because an adult cannot make health care decisions, the guardian gives permission. The patient is still addressed directly and told what will happen in simple terms.

    Why the other options are wrong

    • ABringing a patient to a visit gives no legal authority to consent.
    • BA court has found he cannot make these decisions, so his agreement alone is not legal consent, though his cooperation is still sought.
    • CAn order shows the test is needed but does not replace consent from the patient or guardian.

18. Question 18 of 25Medium

    Which instruction is correct for a semen specimen collected at home for fertility testing?

    1. AA. Refrigerate the specimen until you can bring it in
    2. BB. Use a regular condom to collect the specimen
    3. CC. Keep it near body temperature and deliver it promptly
    4. DD. Bring it in within 24 hours in any clean jar
    Show answer to question 18

    Answer: C. Keep it near body temperature and deliver it promptly

    Sperm motility declines with cold and with time, so the specimen is kept near body temperature, for example inside a coat pocket, and delivered within the time the laboratory specifies, often about 1 hour.

    Why the other options are wrong

    • ACold temperatures reduce sperm motility and give inaccurate results.
    • BRegular condoms often contain spermicides or lubricants that damage sperm.
    • DA 24-hour delay destroys motility, and the specimen requires the container the lab provides.

19. Question 19 of 25Hard

    A 48-year-old man at an outpatient draw station has an order for a fasting blood glucose. During the interview, he says he ate a muffin and drank juice an hour ago. What should the phlebotomist do?

    1. AA. Collect it and label it fasting since the meal was small
    2. BB. Explain the fasting rule, then contact the provider
    3. CC. Have him drink water, wait 30 minutes, then collect it
    4. DD. Collect it without comment, since food will not matter
    Show answer to question 19

    Answer: B. Explain the fasting rule, then contact the provider

    A glucose drawn soon after eating does not reflect a fasting level. The phlebotomist explains why and follows facility policy: contact the ordering provider, who may reschedule the test or approve a draw labeled nonfasting.

    Why the other options are wrong

    • ALabeling a nonfasting specimen as fasting misrepresents it and could lead to a wrong diagnosis.
    • CDrinking water and waiting a short time does not restore a fasting state.
    • DFood raises blood glucose, so his nonfasting status cannot be ignored.

20. Question 20 of 25Hard

    A man who is unconscious and has no wallet or ID is brought to the emergency department after a car crash, and STAT blood work is ordered. How should he be identified for specimen collection?

    1. AA. Wait for police or family to confirm his name before any STAT draw
    2. BB. Collect the specimens now and attach an ID band after results return
    3. CC. Label the tubes "Unknown male" and add his real name once known
    4. DD. Use the temporary name and unique number assigned at registration
    Show answer to question 20

    Answer: D. Use the temporary name and unique number assigned at registration

    Unidentified emergency patients are registered under a temporary name and unique number, placed on an attached ID band per facility protocol. Specimens are labeled with these, and records are linked once his identity is confirmed.

    Why the other options are wrong

    • AWaiting for confirmation would delay urgent testing; the temporary ID exists for this situation.
    • BIdentification must be in place before collection, not after testing.
    • CA generic label without the assigned unique number could be confused with another unidentified patient.

21. Question 21 of 25Medium

    At 0500, a phlebotomist enters the room of a 63-year-old woman for a routine morning draw and finds her asleep. What is the correct approach?

    1. AA. Check her ID band and draw quietly so her sleep is not disturbed
    2. BB. Skip the draw and write on the requisition that she was asleep
    3. CC. Have the nurse confirm her identity so the draw can be done asleep
    4. DD. Wake her gently and let her orient before identifying her
    Show answer to question 21

    Answer: D. Wake her gently and let her orient before identifying her

    Blood is never drawn from a sleeping patient. Waking her gently and allowing time to orient lets her take part in identification and consent and avoids a startle that could cause injury.

    Why the other options are wrong

    • ADrawing during sleep skips verbal identification and consent and risks injury if she wakes suddenly.
    • BSleep is not a reason to miss a routine morning collection.
    • CNurse confirmation does not replace waking a patient who is able to respond.

22. Question 22 of 25Easy

    According to CLSI guidance, which antecubital vein is the first choice for venipuncture when it is suitable?

    1. AA. Basilic vein
    2. BB. Cephalic vein
    3. CC. Median cubital vein
    4. DD. Brachial vein
    Show answer to question 22

    Answer: C. Median cubital vein

    The median cubital vein is preferred because it is usually large, well anchored, close to the surface and less painful to puncture. The cephalic vein is the next choice, and the basilic vein is the last.

    Why the other options are wrong

    • AThe basilic vein is the last antecubital choice, not the first.
    • BThe cephalic vein is acceptable but is considered after the median cubital vein.
    • DThe brachial vein lies deep beside the brachial artery and is not used for routine venipuncture.

23. Question 23 of 25Easy

    A requisition for a hospital patient is marked STAT. What does this priority tell the phlebotomist?

    1. AA. Collect it at the exact clock time that is written on the order
    2. BB. Collect it during the next scheduled round of routine collections
    3. CC. Collect it at once, because the result is needed for urgent care
    4. DD. Collect it later the same day at a time that suits the patient
    Show answer to question 23

    Answer: C. Collect it at once, because the result is needed for urgent care

    STAT comes from the Latin statim, meaning immediately. STAT specimens are collected, delivered and tested ahead of all other requests because the result is needed for urgent or critical care.

    Why the other options are wrong

    • ACollection at a set clock time describes a timed request.
    • BWaiting for the next scheduled round describes routine priority.
    • DCollection at the patient's convenience later in the day describes a routine outpatient draw, not an urgent one.

24. Question 24 of 25Medium

    A 30-year-old man at an outpatient draw station asks, 'Is this going to hurt?' Which response is best?

    1. AA. No, you will not feel anything at all.
    2. BB. You'll feel a quick stick; I'll warn you first.
    3. CC. Only if you are not brave about it.
    4. DD. That depends on how good your veins are today.
    Show answer to question 24

    Answer: B. You'll feel a quick stick; I'll warn you first.

    An honest, calm answer builds trust: he will feel a brief stick, and the phlebotomist will warn him just before it happens. Patients cope better when they know what to expect.

    Why the other options are wrong

    • APromising no sensation is untrue and damages trust when he feels the stick.
    • CJudging the patient's courage is disrespectful and unprofessional.
    • DThis answer avoids the question and can increase his anxiety.

25. Question 25 of 25Medium

    A man arrives at a hospital outpatient laboratory and says he has never been a patient there. Before creating a new account, what should the phlebotomist do first?

    1. AA. Search the system for an existing record by full name and date of birth
    2. BB. Use his Social Security number as the account's medical record number
    3. CC. Ask him to complete the registration at home and return another day
    4. DD. Create the account at once to keep his waiting time as short as possible
    Show answer to question 25

    Answer: A. Search the system for an existing record by full name and date of birth

    Searching first prevents duplicate records. Patients sometimes forget an earlier visit, and a second record splits the history, which can lead to identification errors and missed results.

    Why the other options are wrong

    • BThe facility's system assigns medical record numbers, and a Social Security number needs extra privacy protection.
    • CRegistration can be completed at the visit, so sending him away delays the ordered testing.
    • DSpeed does not justify skipping the search, since duplicate records create safety and billing problems.

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