Phlebotomy Technician Certification Exam
Patient Identification & Quality Practice Questions
60 practice questions with detailed explanations — aligned to the Phlebotomy Technician Certification Exam.
Master Patient Identification & Quality 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.
Q1.The MINIMUM acceptable patient identification for routine inpatient blood collection requires:
A.Verbally confirming the patient's name with nursing staffB.Asking the patient to state their full name and date of birth, then confirming against the order and wristbandC.Checking the room number and bed assignment onlyD.Confirming the patient's name by reading the hospital wristband without asking the patientB. Asking the patient to state their full name and date of birth, then confirming against the order and wristbandExplanation: Proper patient identification requires at least two patient-specific identifiers. The phlebotomist must ask the patient to actively state their full name and date of birth (open-ended, not 'Are you John Smith?'), then compare this information against the requisition/order AND the patient's wristband. Passive confirmation is not acceptable.
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Q2.A patient's identification wristband is missing. The phlebotomist should:
A.Collect the blood using the room number and bed label as identifiersB.Ask a family member in the room to confirm the patient's nameC.Contact the nursing staff to have a new wristband applied before collectingD.Proceed using the requisition form as the sole identifierC. Contact the nursing staff to have a new wristband applied before collectingExplanation: If a patient's identification wristband is missing or unreadable, the specimen must not be collected until a new wristband is properly placed and verified by nursing staff. A room number or family member confirmation does not constitute a valid patient identifier and poses a serious patient safety risk.
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Q3.Hemolysis of a specimen will cause a FALSELY ELEVATED result for which analyte?
A.SodiumB.PotassiumC.GlucoseD.CalciumB. PotassiumExplanation: Red blood cells contain high concentrations of potassium. When hemolysis occurs, intracellular potassium is released into the serum/plasma, causing a falsely elevated potassium (hyperkalemia) result. Hemolysis also falsely elevates LDH, AST, and magnesium, and can interfere with many other chemistry analytes.
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Q4.Which of the following is a VALID reason to reject a specimen upon receipt in the laboratory?
A.The specimen was collected by a float phlebotomist, not the regular staffB.The tube is completely full rather than partially fullC.The specimen label does not match the patient's requisition informationD.The tube was collected using a butterfly needleC. The specimen label does not match the patient's requisition informationExplanation: A mislabeled specimen — where the label information does not match the requisition or order — is a critical specimen rejection criterion. Testing a mislabeled specimen can lead to life-threatening errors. Other valid rejection criteria include unlabeled tubes, hemolysis, QNS, incorrect tube type, clotted anticoagulated specimens, and improper storage or transport.
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Q5.A patient is unconscious and has no identification wristband. What is the correct procedure for specimen collection?
A.Do not collect any specimens until the patient is identifiedB.Use an emergency identification protocol, assigning a temporary ID, and apply a wristband before collectionC.Collect the specimen using the room number as the identifierD.Ask any available family member to verbally identify the patientB. Use an emergency identification protocol, assigning a temporary ID, and apply a wristband before collectionExplanation: For unconscious patients without identification, facilities have emergency identification protocols (often assigning a temporary 'John Doe' number with unique identifiers). A wristband with this temporary identification must be applied before specimen collection to maintain a valid chain of identity and ensure results are linked to the correct patient.
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Q6.Which of the following BEST describes a 'lipemic' specimen?
A.A specimen with visible hemolysis making it appear red or pinkB.A specimen appearing yellow-green due to elevated bilirubinC.A specimen appearing milky or turbid due to elevated triglyceridesD.A specimen that has been diluted with IV fluidsC. A specimen appearing milky or turbid due to elevated triglyceridesExplanation: Lipemia refers to elevated lipid content (primarily triglycerides) in the blood, causing the serum or plasma to appear milky, turbid, or cloudy. It most commonly occurs when blood is drawn from a non-fasting patient. Lipemia can interfere with photometric assays by scattering light, causing inaccurate results for many chemistry panels.
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Q7.A phlebotomist collects a blue-top tube for a PT/INR from a patient on warfarin therapy, but the tube is only 60% full. The phlebotomist should:
A.Submit the specimen and note the underfill on the requisitionB.Recollect the specimen with a smaller-volume blue-top tube or recollect a full-sized tubeC.Top off the tube with saline to reach the fill lineD.Centrifuge and use only the plasma portionB. Recollect the specimen with a smaller-volume blue-top tube or recollect a full-sized tubeExplanation: Underfilled citrate tubes have an excess of sodium citrate relative to blood, which artificially prolongs PT/INR and aPTT values. The specimen must be recollected. If insufficient blood volume is anticipated, a smaller-volume (pediatric) blue-top tube should be used, or the tube should be filled completely.
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Q8.Which condition describes a specimen that has been drawn proximal to (above) an IV infusion site on the same arm?
A.The specimen is acceptable as long as the IV has been running for more than 30 minutesB.The specimen is diluted with IV fluid and will yield inaccurate resultsC.The specimen is acceptable because the flow of blood is distal to the IVD.The specimen is only unacceptable if the IV contains heparinB. The specimen is diluted with IV fluid and will yield inaccurate resultsExplanation: Drawing blood from an arm with an active IV line, proximal to the IV site, will result in dilution of the blood specimen with the IV fluid. This leads to inaccurate results for virtually all analytes. Blood should be drawn from the opposite arm, or from a site distal to the IV after the IV has been turned off for at least 2 minutes and the first 5 mL of blood discarded.
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Q9.The term 'chain of custody' in phlebotomy is MOST important when collecting specimens for:
A.Routine chemistry panelsB.Drug and alcohol testing or forensic specimensC.Blood culturesD.Allergy testingB. Drug and alcohol testing or forensic specimensExplanation: Chain of custody (COC) is a legally defensible documentation process tracking specimen handling from collection to reporting. It is mandatory for forensic specimens, workplace drug testing, blood alcohol, and medicolegal cases. COC ensures the specimen was not tampered with or substituted, and every person who handled the specimen is documented.
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Q10.If a patient refuses to have their blood drawn, the phlebotomist MUST:
A.Restrain the patient and collect the specimen as ordered by the physicianB.Respect the refusal, document it, and notify the nursing staff and/or ordering physicianC.Ask the patient's family to convince the patient to cooperateD.Wait 30 minutes and attempt the draw again without informing anyoneB. Respect the refusal, document it, and notify the nursing staff and/or ordering physicianExplanation: Competent adult patients have the legal and ethical right to refuse any medical procedure, including venipuncture. The phlebotomist must respect this refusal, document it thoroughly in the medical record (noting patient stated refusal), and immediately notify the nursing staff and the ordering provider so clinical care decisions can be adjusted.
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