Skip to main content

Phlebotomy Technician Certification Exam

Order of Draw Practice Questions

60 practice questions with detailed explanations — aligned to the Phlebotomy Technician Certification Exam.

Master Order of Draw to boost your score on the Phlebotomy Technician Certification Exam. Each question below mirrors the style and difficulty of real exam questions, complete with detailed explanations so you understand the why behind every answer. Work through all 60 questions, review any that trip you up, and use the related topics below to round out your preparation.

  1. Q1.According to CLSI guidelines, which of the following represents the correct order of draw for evacuated tubes?

    A.Yellow, Blue, Red/Gold, Green, Lavender, Gray
    B.Blue, Yellow, Red/Gold, Green, Lavender, Gray
    C.Yellow, Red/Gold, Blue, Green, Lavender, Gray
    D.Red/Gold, Blue, Yellow, Lavender, Green, Gray
    AYellow, Blue, Red/Gold, Green, Lavender, Gray

    Explanation: The CLSI-recommended order of draw for evacuated tubes is: Yellow (SPS/blood culture), Blue (sodium citrate), Red or Gold (serum/SST), Green (heparin), Lavender (EDTA), Gray (fluoride/oxalate). This sequence prevents cross-contamination of additives between tubes.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  2. Q2.A lavender-top tube contains which anticoagulant?

    A.Sodium citrate
    B.Lithium heparin
    C.EDTA (ethylenediaminetetraacetic acid)
    D.Sodium fluoride
    CEDTA (ethylenediaminetetraacetic acid)

    Explanation: Lavender-top tubes contain EDTA (ethylenediaminetetraacetic acid), which chelates calcium ions to prevent clotting. EDTA tubes are the standard for complete blood count (CBC) and other hematology tests because they preserve cell morphology.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  3. Q3.Which tube is ALWAYS drawn first when collecting blood cultures?

    A.Lavender-top tube
    B.Yellow-top tube (blood culture bottle)
    C.Blue-top tube
    D.Red-top tube
    BYellow-top tube (blood culture bottle)

    Explanation: Blood culture bottles (yellow-top SPS tubes or aerobic/anaerobic bottles) are always collected first to minimize the risk of contamination from skin flora and to ensure the sample is not contaminated by additives from other tubes.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  4. Q4.A gray-top tube is PRIMARILY used for which laboratory test?

    A.Complete blood count (CBC)
    B.Prothrombin time (PT)
    C.Glucose and blood alcohol levels
    D.Serum electrolytes
    CGlucose and blood alcohol levels

    Explanation: Gray-top tubes contain sodium fluoride (a glycolytic inhibitor) and potassium oxalate (an anticoagulant). Sodium fluoride inhibits glycolysis and preserves glucose levels, making this tube the choice for glucose tolerance tests and blood alcohol specimens.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  5. Q5.Why must the blue-top (sodium citrate) tube be filled to the correct volume?

    A.Underfilling will cause hemolysis of the sample
    B.The citrate-to-blood ratio must be exactly 1:9 for accurate coagulation results
    C.Overfilling will activate platelets prematurely
    D.The tube vacuum will collapse the vein if underfilled
    BThe citrate-to-blood ratio must be exactly 1:9 for accurate coagulation results

    Explanation: Sodium citrate tubes must maintain a precise 1:9 anticoagulant-to-blood ratio. An underfilled tube has excess citrate relative to the blood, which will artificially prolong PT and aPTT values. Overfilling introduces too much calcium-containing blood and can cause clotting.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  6. Q6.A gold-top or red/gray SST (serum separator tube) contains which additive?

    A.EDTA and a clot activator
    B.A thixotropic gel and a clot activator
    C.Lithium heparin and a thixotropic gel
    D.Sodium citrate only
    BA thixotropic gel and a clot activator

    Explanation: Serum Separator Tubes (SST) contain a thixotropic gel that migrates between the clot and serum during centrifugation, and a clot activator (silica particles) to speed clot formation. After centrifugation, the gel barrier separates serum from the clot for chemistry testing.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  7. Q7.Which tube additive is used for lead and trace element testing to prevent contamination?

    A.Standard EDTA lavender-top
    B.Royal blue-top tube with EDTA or no additive
    C.Green-top lithium heparin
    D.Red-top with clot activator
    BRoyal blue-top tube with EDTA or no additive

    Explanation: Royal blue-top tubes are manufactured with special low-metal rubber stoppers and ultra-pure additives to prevent trace metal contamination. They are available with EDTA (for whole blood trace elements), with sodium heparin, or with no additive (for serum trace elements).

    Join 1,000+ users passing the Phlebotomy Technician Certification

  8. Q8.When drawing from a butterfly (winged infusion set) with a blue-top tube as the first tube, what should the phlebotomist do?

    A.Draw the blue-top tube directly without any preliminary step
    B.Draw a small discard red or clear tube first to fill the tubing dead space
    C.Invert the blue tube 10 times immediately after collection
    D.Apply extra pressure to the site after collection
    BDraw a small discard red or clear tube first to fill the tubing dead space

    Explanation: When using a butterfly set, the tubing contains air that will enter the tube first, underfilling the blue-top and altering the citrate-to-blood ratio. A small discard tube (red or clear) is collected first to fill the dead space of the tubing before collecting the blue-top tube.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  9. Q9.Green-top tubes contain which anticoagulant and are MOST commonly used for which tests?

    A.EDTA; used for hematology panels
    B.Sodium fluoride; used for glucose testing
    C.Heparin (lithium or sodium); used for plasma chemistry and stat electrolytes
    D.Sodium citrate; used for coagulation studies
    CHeparin (lithium or sodium); used for plasma chemistry and stat electrolytes

    Explanation: Green-top tubes contain heparin (lithium or sodium heparin), which inhibits thrombin and prevents clot formation. They are used for stat plasma chemistry tests and electrolyte panels because plasma can be obtained quickly without waiting for the clot to form.

    Join 1,000+ users passing the Phlebotomy Technician Certification

  10. Q10.How many times should a lavender-top EDTA tube be gently inverted after collection?

    A.0 times (do not mix)
    B.3–4 times
    C.8–10 times
    D.15–20 times
    C8–10 times

    Explanation: EDTA tubes should be gently inverted 8–10 times immediately after collection to ensure thorough mixing of blood with the anticoagulant and prevent microclot formation, which would interfere with CBC results. Vigorous shaking should be avoided to prevent hemolysis.

    Join 1,000+ users passing the Phlebotomy Technician Certification

Want all 300 questions?

Download VoltExam — $24.99 Lifetime

Offline access, 300+ questions, built-in calculators. One-time unlock, no subscription.

Download on the App Store

More Phlebotomy Technician Certification Exam Topics