Phlebotomy Safety and Compliance Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Hard

   At a hospital outpatient laboratory, a phlebotomist notices that a coworker smells strongly of alcohol, has slurred speech and is about to draw blood from a 4-year-old child. What is the best action?

   1. AA. Say nothing now and raise it at the next staff meeting
   2. BB. Ask other coworkers whether they have noticed the same thing
   3. CC. Offer to take over the coworker's draws for the rest of the shift
   4. DD. Report the concern to the supervisor right away
   Show answer to question 1

   Answer: D. Report the concern to the supervisor right away

   A coworker who appears impaired puts patients at immediate risk, so the concern must go to the supervisor at once so the person can be removed from patient care and the situation handled per policy.

   Why the other options are wrong

   • AWaiting for a meeting leaves patients exposed to an unsafe practitioner today.
   • BDiscussing the coworker with others spreads gossip and delays protecting patients.
   • CCovering for an impaired coworker hides the problem and does not ensure patient safety.

2. Question 2 of 25Medium

   Under the Globally Harmonized System (GHS), Safety Data Sheets (SDSs) use a standardized 16-section format. Which section provides information regarding exposure limits, engineering controls, and recommended personal protective equipment (PPE)?

   1. AA. Section 4 (First-Aid Measures)
   2. BB. Section 13 (Disposal Considerations)
   3. CC. Section 11 (Toxicological Information)
   4. DD. Section 8 (Exposure Controls/Personal Protection)
   Show answer to question 2

   Answer: D. Section 8 (Exposure Controls/Personal Protection)

   Section 8 of an SDS outlines workplace exposure limits, engineering controls, and personal protective equipment necessary to minimize exposure. While Section 4 addresses initial emergency medical steps following accidental contact, Section 8 focuses on routine barrier protection and preventive workplace controls.

3. Question 3 of 25Medium

   An adult outpatient stands up after his blood draw, says the room is spinning and slumps to the floor. He is breathing and begins to respond within seconds. What should the phlebotomist do?

   1. AA. Help him stand up and walk him back to the draw chair
   2. BB. Keep him lying down, call for help and stay with him
   3. CC. Hold an ammonia inhalant under his nose
   4. DD. Give him a glass of water while he lies flat
   Show answer to question 3

   Answer: B. Keep him lying down, call for help and stay with him

   A patient who has fainted is kept lying down until fully recovered, help is called per facility protocol, and the phlebotomist stays with him, watches his breathing and checks for injuries from the fall.

   Why the other options are wrong

   • AGetting up too soon can cause another faint and a second fall.
   • CAmmonia inhalants are not recommended because they can irritate the airway or cause a sudden head movement that leads to injury.
   • DGiving fluids to a person lying flat who is not fully alert risks choking.

4. Question 4 of 25Easy

   What should a phlebotomist do before stepping away from a workstation that has a patient's laboratory orders open on the screen?

   1. AA. Turn the monitor slightly toward the wall
   2. BB. Lock the screen or log off the system
   3. CC. Ask a nearby visitor to keep an eye on it
   4. DD. Minimize the window and leave it running
   Show answer to question 4

   Answer: B. Lock the screen or log off the system

   Locking the screen or logging off keeps others from viewing or using the record under the phlebotomist's login, a basic HIPAA safeguard.

   Why the other options are wrong

   • ATurning the monitor still leaves the record open to anyone who walks up to the workstation.
   • CA visitor has no role in protecting the system and could view PHI.
   • DA minimized window can be reopened by anyone using the unlocked workstation.

5. Question 5 of 25Medium

   At a physician office, a phlebotomist finds an opened bottle of glucose control solution with no date written on it. The printed expiration date has not passed. What should she do?

   1. AA. Use it, since the printed expiration date is still in the future
   2. BB. Use it, but run each control level twice to be safe
   3. CC. Discard it and open a new bottle, writing the open date on it
   4. DD. Estimate when it was opened and write that date on the label
   Show answer to question 5

   Answer: C. Discard it and open a new bottle, writing the open date on it

   Control solutions have an open-vial expiration that starts when the bottle is opened. Without a written open date, there is no way to know whether it has expired, so it is discarded and a new bottle is dated when opened.

   Why the other options are wrong

   • AThe printed date alone is not enough; once a bottle is opened, the open-vial period also applies, and whichever ends first governs.
   • BRunning controls twice does not show whether the solution is still within its usable period.
   • DWriting an estimated date creates a false record.

6. Question 6 of 25Medium

   An outpatient phlebotomist draws blood from a 52-year-old man with chronic hepatitis B infection. In the chain of infection, what does this patient represent?

   1. AA. The portal of entry
   2. BB. The reservoir
   3. CC. The mode of transmission
   4. DD. The susceptible host
   Show answer to question 6

   Answer: B. The reservoir

   A reservoir is where an infectious agent lives and multiplies. A person with chronic hepatitis B infection is a human reservoir of the virus, and his blood can transmit it to others.

   Why the other options are wrong

   • AA portal of entry is the route into a new host, such as a needlestick wound or mucous membrane.
   • CThe mode of transmission is how the agent travels, such as on a contaminated needle.
   • DThe patient is already infected; a susceptible host is a person who could become infected.

7. Question 7 of 25Hard

   To save time at a busy urgent care clinic, a staff member proposes reading every pad on the urine reagent strip at 60 seconds, although the package insert lists different read times for different pads. Which statement is accurate?

   1. AA. Changing the procedure means the test is no longer waived.
   2. BB. The change is acceptable as long as all results are documented.
   3. CC. The change is acceptable for screening but not for diagnosis.
   4. DD. The change is acceptable as long as the controls are in range.
   Show answer to question 7

   Answer: A. Changing the procedure means the test is no longer waived.

   Waived tests must be performed exactly as the manufacturer directs. Under CLIA, a modified waived test is treated as high complexity, which a site with only a Certificate of Waiver cannot perform, and the results may be inaccurate.

   Why the other options are wrong

   • BDocumenting results does not fix a procedure that departs from the manufacturer's instructions.
   • CWaived status does not allow procedure changes for any purpose, including screening.
   • DAcceptable controls do not make an unapproved change to the procedure acceptable.

8. Question 8 of 25Medium

   After unpacking supply boxes from a dusty storage room, a phlebotomist at a physician office sees that her hands are visibly dirty. What should she do before her next patient?

   1. AA. Use alcohol-based hand rub, then put on gloves
   2. BB. Put on gloves, since they will cover the dirt
   3. CC. Wash her hands with soap and water
   4. DD. Wipe her hands with a dry paper towel
   Show answer to question 8

   Answer: C. Wash her hands with soap and water

   Alcohol-based hand rub does not work well on hands that are visibly dirty, so visibly soiled hands are washed with soap and water.

   Why the other options are wrong

   • AHand rub does not remove dirt and organic material, which also reduce its effectiveness.
   • BGloves are not a substitute for hand hygiene, and gloving over dirty hands contaminates the gloves.
   • DA dry towel does not reliably remove soil or organisms from the hands.

9. Question 9 of 25Hard

   A phlebotomist at an outpatient draw station develops weeping dermatitis on both hands. Which action best protects patients and the phlebotomist?

   1. AA. Cover the lesions with gloves and continue all of the draws as usual
   2. BB. Report it to employee health and stay off patient care until cleared
   3. CC. Apply alcohol hand rub often to dry out the lesions between patients
   4. DD. Wear two pairs of gloves and skip hand hygiene to avoid irritation
   Show answer to question 9

   Answer: B. Report it to employee health and stay off patient care until cleared

   Weeping skin is a portal of entry for bloodborne pathogens and a possible source of organisms. Health care personnel with weeping dermatitis should refrain from direct patient care and handling patient-care equipment until the condition resolves, as directed by employee health.

   Why the other options are wrong

   • AGloves can leak or tear, and weeping skin under them remains a portal of entry.
   • CFrequent alcohol on open lesions causes pain and further skin breakdown without removing the risk.
   • DHand hygiene is never skipped, and double gloving does not make weeping skin safe for patient care.

10. Question 10 of 25Medium

    A hospital phlebotomist sees on the census that her neighbor has been admitted to a unit she does not cover. Out of concern, she opens the neighbor's laboratory results but tells no one what she saw. Which statement is accurate?

    1. AA. It is a violation, since she had no job-related reason to view them.
    2. BB. It is acceptable, since she did not share the results with anyone.
    3. CC. It is acceptable, since she is an employee with access to the system.
    4. DD. It is a violation only if the neighbor later files a complaint.
    Show answer to question 10

    Answer: A. It is a violation, since she had no job-related reason to view them.

    Workforce members may access PHI only as needed for their job duties. Viewing a record out of personal curiosity or concern is an impermissible use, even if nothing is shared.

    Why the other options are wrong

    • BImproper viewing is itself a violation; sharing the information is not required.
    • CSystem access does not authorize viewing records unrelated to assigned work.
    • DThe violation occurs when the record is improperly accessed, whether or not a complaint is filed.

11. Question 11 of 25Easy

    According to current AHA BLS guidelines, what chest compression rate is recommended for an adult in cardiac arrest?

    1. AA. 40 to 60 per minute
    2. BB. 60 to 80 per minute
    3. CC. 80 to 100 per minute
    4. DD. 100 to 120 per minute
    Show answer to question 11

    Answer: D. 100 to 120 per minute

    AHA BLS guidelines call for compressions at 100 to 120 per minute, fast enough to circulate blood but slow enough for the heart to refill between compressions.

    Why the other options are wrong

    • AThis rate is far too slow to keep blood flowing to the brain and heart.
    • BCompressions at this rate move too little blood each minute to support the brain and heart.
    • CThis rate is still below the recommended range and lowers blood flow.

12. Question 12 of 25Medium

    A caller tells an outpatient laboratory phlebotomist that she is the daughter of an 81-year-old man drawn that morning. She gives his date of birth and asks for his potassium result. What should the phlebotomist do?

    1. AA. Not release the result and follow policy for referring the request
    2. BB. Give the result, because the caller knows the patient's birth date
    3. CC. Say the result is normal without giving the actual number
    4. DD. Read the result once the caller confirms her own name and address
    Show answer to question 12

    Answer: A. Not release the result and follow policy for referring the request

    Knowing a patient's date of birth does not show that a caller is authorized to receive results. The phlebotomist should not release results and should refer the request as facility policy directs, usually to the ordering provider.

    Why the other options are wrong

    • BA date of birth is easy for others to know and does not prove the caller is authorized.
    • CSaying a result is normal is still a disclosure of his health information.
    • DThe caller's own name and address do not show that the patient authorized her to receive his results.

13. Question 13 of 25Hard

    Over five days, the daily readings for a specimen refrigerator with an acceptable range of 2 to 8 C (36 to 46 F) were 4, 5, 6, 7 and 7.5 C. All are in range. What is the best action for the phlebotomist reviewing the log?

    1. AA. Take no action, since every reading is still within the range
    2. BB. Report the steady upward trend to the supervisor
    3. CC. Widen the acceptable range so the log shows fewer problems
    4. DD. Move the thermometer deeper into the unit so readings drop
    Show answer to question 13

    Answer: B. Report the steady upward trend to the supervisor

    Quality assurance looks for trends, not only single failures. A steady climb toward the upper limit suggests a developing problem, such as a failing door seal or compressor, that should be reported before stored items are affected.

    Why the other options are wrong

    • AWaiting for an out-of-range reading risks losing specimens and reagents that the trend could have protected.
    • CChanging the acceptable range hides the problem and is not the phlebotomist's decision.
    • DMoving the thermometer to get lower numbers manipulates the log instead of addressing the problem.

14. Question 14 of 25Hard

    At the start of the day shift in a hospital laboratory, a phlebotomist checks the specimen refrigerator and reads 12 C (53.6 F). The posted acceptable range is 2 to 8 C (36 to 46 F). What should she do?

    1. AA. Record 8 C in the log, since the unit will probably cool down before the next check
    2. BB. Turn the thermostat colder and record nothing until the reading is back in range
    3. CC. Record the actual reading, notify the supervisor and follow the written procedure
    4. DD. Discard every specimen and reagent in the refrigerator right away and restock it
    Show answer to question 14

    Answer: C. Record the actual reading, notify the supervisor and follow the written procedure

    The log must show the real reading. An out-of-range temperature is reported and handled by the written procedure, which usually includes moving contents to a unit that is in range and documenting corrective action.

    Why the other options are wrong

    • AWriting a reading that was not observed falsifies the log and hides a storage problem.
    • BAdjusting the unit without documenting the excursion leaves no record for judging whether the contents are still usable.
    • DWhether contents must be discarded is decided through the procedure and the supervisor, not by automatic disposal.

15. Question 15 of 25Easy

    Under standard precautions, which body substance is the one exception that is not treated as potentially infectious?

    1. AA. Saliva
    2. BB. Sweat
    3. CC. Urine
    4. DD. Vomit
    Show answer to question 15

    Answer: B. Sweat

    Standard precautions assume that blood and all body fluids, secretions and excretions except sweat, along with nonintact skin and mucous membranes, may contain infectious agents.

    Why the other options are wrong

    • ASaliva is a secretion and is handled as potentially infectious under standard precautions.
    • CUrine is an excretion and is treated as potentially infectious, so gloves are worn when handling it.
    • DVomit is covered by standard precautions and calls for gloves and other PPE based on the expected exposure.

16. Question 16 of 25Easy

    Receiving the hepatitis B vaccine breaks the chain of infection at which link?

    1. AA. Reservoir
    2. BB. Portal of exit
    3. CC. Mode of transmission
    4. DD. Susceptible host
    Show answer to question 16

    Answer: D. Susceptible host

    Vaccination makes the worker immune, so a person who would otherwise be a susceptible host can no longer be infected by the virus.

    Why the other options are wrong

    • AThe vaccine does not remove the virus from infected people, who remain the reservoir.
    • BThe portal of exit is how the virus leaves an infected person, which the worker's vaccination does not change.
    • CVaccination does not stop blood or needles from carrying the virus; it protects the exposed person.

17. Question 17 of 25Medium

    Under the OSHA Bloodborne Pathogens Standard, which body fluid is classified as other potentially infectious material (OPIM)?

    1. AA. Tears
    2. BB. Sweat
    3. CC. Cerebrospinal fluid
    4. DD. Urine with no visible blood
    Show answer to question 17

    Answer: C. Cerebrospinal fluid

    OSHA lists cerebrospinal fluid as OPIM, along with semen, vaginal secretions, synovial, pleural, pericardial, peritoneal and amniotic fluid, and any body fluid visibly contaminated with blood.

    Why the other options are wrong

    • ATears are not OPIM under the standard unless they are visibly contaminated with blood.
    • BSweat is not OPIM under the standard and is not considered a bloodborne pathogen risk.
    • DUrine is OPIM under the standard only when it is visibly contaminated with blood.

18. Question 18 of 25Medium

    At a community health fair with no sink nearby, a phlebotomist's glove tears and blood gets on his intact hand. What should he do?

    1. AA. Use antiseptic towelettes now, then wash with soap at a sink soon
    2. BB. Put a new glove on over the blood and finish the screening line
    3. CC. Wipe the blood away with dry gauze and then keep working as usual
    4. DD. Rinse it with bottled water and skip any further hand washing
    Show answer to question 18

    Answer: A. Use antiseptic towelettes now, then wash with soap at a sink soon

    When handwashing facilities are not available, OSHA requires the employer to provide an antiseptic hand cleanser or towelettes, followed by washing with soap and running water as soon as feasible.

    Why the other options are wrong

    • BGloving over blood leaves contamination on the skin and spreads it to the new glove.
    • CDry gauze removes only some of the blood and does not clean the skin.
    • DBottled water alone does not clean the skin, and washing with soap and running water is still required.

19. Question 19 of 25Medium

    A patient fell in the outpatient draw area, and the phlebotomist found her on the floor. Which statement is most appropriate for the incident report?

    1. AA. Patient found seated on floor by draw chair, 10:15 a.m.
    2. BB. Patient fell because she was not paying attention.
    3. CC. The floor was probably wet, so housekeeping is at fault.
    4. DD. The fall seemed minor, so no follow-up is needed.
    Show answer to question 19

    Answer: A. Patient found seated on floor by draw chair, 10:15 a.m.

    An incident report records objective facts: what was seen, heard and done, with times, and no opinions, guesses or blame.

    Why the other options are wrong

    • BThe reason for the fall is an assumption about the patient, not an observed fact.
    • CGuessing at causes and assigning blame do not belong in an incident report.
    • DThe writer does not judge the significance of the event; falls are reported and reviewed per facility policy.

20. Question 20 of 25Easy

    While filling in the freezer temperature log at a reference laboratory, a phlebotomist writes -12 C (10.4 F) when the thermometer actually reads -21 C (-5.8 F). How should she correct the entry?

    1. AA. Cover the wrong number with correction fluid and write in the right one
    2. BB. Scribble over the wrong number until it can no longer be read
    3. CC. Draw a single line through it, add the right value, initial and date it
    4. DD. Tear out the page and copy all the entries onto a fresh sheet
    Show answer to question 20

    Answer: C. Draw a single line through it, add the right value, initial and date it

    A single line keeps the original entry readable, and adding the correct value with initials and the date shows who made the change and when, which keeps the record trustworthy.

    Why the other options are wrong

    • ACorrection fluid hides the original entry, so the change cannot be verified.
    • BObliterating an entry makes the record look altered and prevents review.
    • DRemoving and recopying a page destroys the original record.

21. Question 21 of 25Medium

    A man's convulsive seizure in the outpatient lab has just ended. He is breathing but drowsy and has saliva in his mouth. What should the phlebotomist do until help arrives?

    1. AA. Turn him onto his side and stay with him
    2. BB. Give him sips of water to clear his mouth
    3. CC. Sit him upright in the draw chair at once
    4. DD. Leave to find his chart and emergency contact
    Show answer to question 21

    Answer: A. Turn him onto his side and stay with him

    After the jerking stops, turning the person onto the side (recovery position) helps keep the airway open and lets saliva drain, and someone stays with him until he is fully alert or help takes over.

    Why the other options are wrong

    • BNothing is given by mouth until the person is fully alert, because he could choke.
    • CA drowsy person placed upright may slump or fall and cannot protect the airway well.
    • DThe patient must not be left alone while drowsy after a seizure.

22. Question 22 of 25Easy

    A phlebotomist working at a specimen processing counter in a hospital laboratory wants to apply lip balm. What does the OSHA Bloodborne Pathogens Standard require?

    1. AA. Lip balm is allowed if gloves are removed first
    2. BB. Lip balm is allowed if the counter was disinfected
    3. CC. Lip balm may not be applied in this work area
    4. DD. Lip balm is allowed if it comes from a sealed tube
    Show answer to question 22

    Answer: C. Lip balm may not be applied in this work area

    Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses are prohibited in work areas where occupational exposure is reasonably likely. The phlebotomist should leave the area and wash hands first.

    Why the other options are wrong

    • ARemoving gloves does not make the area safe; the ban applies to the work area itself.
    • BA disinfected counter is still in an area with a reasonable likelihood of exposure.
    • DEven a sealed product can be contaminated by hands or surfaces once opened in the work area.

23. Question 23 of 25Hard

    In a private online group for local health care workers, a member asks whether anyone drew blood from the driver injured in a highway crash that morning. A phlebotomist in the group did draw the driver in the emergency department. What is the most appropriate response?

    1. AA. Reply with the driver's condition but leave out the name
    2. BB. Send the details by direct message instead of in the group
    3. CC. Confirm the draw, since the group is limited to health workers
    4. DD. Share no information about the patient in any form
    Show answer to question 23

    Answer: D. Share no information about the patient in any form

    Confirming that a patient was treated or describing the patient's condition discloses PHI when the patient can be identified from the context. The group has no treatment role, so nothing about the patient should be shared.

    Why the other options are wrong

    • AThe crash details already identify the driver, so describing the condition is still a disclosure.
    • BA direct message is still an unauthorized disclosure to someone with no role in the patient's care.
    • CLimiting membership to health care workers does not create a treatment purpose or permission to share PHI.

24. Question 24 of 25Easy

    At an outpatient draw station, a phlebotomist notices that the sharps container's contents have reached the fill line. What is the correct action?

    1. AA. Press the contents down with a gloved hand to make room
    2. BB. Shake the container gently so the contents settle lower
    3. CC. Keep using it until no more needles fit through the opening
    4. DD. Close and lock the lid and replace it with a new container
    Show answer to question 24

    Answer: D. Close and lock the lid and replace it with a new container

    Sharps containers are replaced routinely and must not be overfilled. When contents reach the fill line, the lid is closed and locked, and the container is replaced and handled as regulated waste per facility policy.

    Why the other options are wrong

    • APressing contents down by hand can drive a needle through the glove and into the skin.
    • BShaking can make sharps protrude or jam the opening, and the container is still full.
    • CFilling past the line causes overfilling, protruding sharps and needlesticks at the opening.

25. Question 25 of 25Hard

    In the emergency department, a phlebotomist disinfects a blood-contaminated tray table with wipes whose label lists a 2-minute wet contact time. The surface dries after 45 seconds. What should she do?

    1. AA. Wipe again so the surface stays wet for the full 2 minutes
    2. BB. Consider it disinfected, since the surface was wiped once
    3. CC. Spray 70% alcohol on it to finish the remaining contact time
    4. DD. Dry the surface with a towel and return the table to use
    Show answer to question 25

    Answer: A. Wipe again so the surface stays wet for the full 2 minutes

    A disinfectant works only if the surface stays wet for the full contact time on its label. If it dries early, more product is applied so the surface remains wet for the entire listed time.

    Why the other options are wrong

    • BOne wipe that dries early has not met the label contact time, so disinfection is incomplete.
    • CAlcohol evaporates quickly and is not the labeled product, so it cannot complete the contact time.
    • DDrying the surface ends contact time early and leaves it inadequately disinfected.

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