Phlebotomy Technician Certification Exam
Specimen Handling & Labeling Practice Questions
60 practice questions with detailed explanations — aligned to the Phlebotomy Technician Certification Exam.
Master Specimen Handling & Labeling 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.Which of the following information is REQUIRED on a specimen label at the time of collection?
A.Patient's full name, date of birth, and the phlebotomist's initialsB.Patient's full name, date of birth, date and time of collection, and collector's IDC.Patient's name, room number, and physician nameD.Patient's insurance information and medical record number onlyB. Patient's full name, date of birth, date and time of collection, and collector's IDExplanation: Per CLSI standards, a properly labeled specimen must include: patient's full name, a unique identifier (date of birth or medical record number), date and time of collection, and the collector's identification. Labels must be applied immediately at the bedside or draw station before leaving the patient.
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Q2.A specimen is labeled AFTER the phlebotomist returns to the lab. This is considered:
A.Acceptable if the phlebotomist collected from only one patientB.A serious error that violates chain-of-custody and patient safety standardsC.Acceptable if the physician ordered a STAT testD.Standard practice for outpatient drawsB. A serious error that violates chain-of-custody and patient safety standardsExplanation: Specimens must be labeled immediately at the patient's side, in the presence of the patient, before leaving the room or collection area. Post-collection labeling is a serious error that can lead to specimen mix-ups, misdiagnosis, and patient harm. It is a specimen rejection criterion at most institutions.
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Q3.Which specimen requires transport in ice water or a cold environment to maintain stability?
A.CBC in an EDTA tubeB.Arterial blood gas (ABG) specimensC.Serum glucose in a gold SSTD.Prothrombin time in a blue-top tubeB. Arterial blood gas (ABG) specimensExplanation: Arterial blood gas specimens must be transported in an ice slurry (ice and water mixture) to slow cellular metabolism and prevent changes in pH, pO2, and pCO2. Specimens not tested within 30 minutes without ice will show falsely decreased pO2 and pH due to ongoing cellular metabolism.
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Q4.A specimen that appears pink or red in the serum or plasma layer MOST likely indicates:
A.Jaundice (hyperbilirubinemia)B.Lipemia from a non-fasting patientC.Hemolysis caused by red blood cell destructionD.Clot formation in the tubeC. Hemolysis caused by red blood cell destructionExplanation: A pink or red serum/plasma indicates hemolysis — the rupture of red blood cells releasing hemoglobin into the fluid. Hemolysis can be caused by traumatic venipuncture, using a small needle with high vacuum, vigorous shaking of the tube, or a contaminated needle. Hemolysis interferes with potassium, LDH, and many other chemistry results.
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Q5.What is the MAXIMUM time a serum tube should stand upright (clot) before centrifugation?
A.5 minutesB.15–30 minutes at room temperatureC.2 hoursD.4 hours refrigeratedB. 15–30 minutes at room temperatureExplanation: Serum tubes (red or gold SST) should be allowed to clot completely for 15–30 minutes at room temperature before centrifugation. Centrifuging too early can result in a fibrin clot forming in the serum after separation, interfering with analyzers. Clotting time may be longer for patients on anticoagulant therapy.
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Q6.Which specimen must be protected from light during transport to preserve the analyte?
A.PotassiumB.Bilirubin and porphyrinsC.CreatinineD.Complete blood count (CBC)B. Bilirubin and porphyrinsExplanation: Bilirubin and porphyrins are light-sensitive analytes. Exposure to light causes photodegradation, falsely lowering bilirubin results. These specimens must be wrapped in aluminum foil or transported in amber-colored tubes or containers to protect them from light.
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Q7.A specimen is received in the lab with a visible clot in a lavender-top (EDTA) tube. The phlebotomist should:
A.Centrifuge the tube and use the plasma above the clotB.Reject the specimen and recollect, as a clot invalidates hematology resultsC.Dissolve the clot by warming the tube to 37°CD.Filter out the clot and run the CBCB. Reject the specimen and recollect, as a clot invalidates hematology resultsExplanation: A clot in an EDTA tube indicates inadequate mixing immediately after collection. Even a small clot in an EDTA tube renders the specimen unsuitable for CBC testing because the clot has consumed platelets and cellular elements, leading to falsely low platelet counts and potentially inaccurate WBC and RBC counts. The specimen must be rejected and a new sample collected.
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Q8.The relative centrifugal force (RCF) used to centrifuge blood specimens is determined by:
A.The temperature of the centrifuge onlyB.The RPM, radius of the centrifuge rotor, and centrifuge timeC.The number of tubes in the centrifugeD.The type of additive in the tubeB. The RPM, radius of the centrifuge rotor, and centrifuge timeExplanation: RCF (measured in 'g') depends on the RPM (revolutions per minute) and the rotor radius. Most blood specimens are centrifuged at 1,000–2,000 RCF (g) for 10–15 minutes. Centrifuge settings must be validated for each tube type, as incorrect RCF can result in incomplete separation or hemolysis.
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Q9.A specimen labeled 'QNS' has been sent to the laboratory. This abbreviation means:
A.Quality Not SufficientB.Quantity Not SufficientC.Question: New SampleD.Quick Notify SupervisorB. Quantity Not SufficientExplanation: QNS stands for 'Quantity Not Sufficient,' meaning there is not enough specimen volume to perform the requested test(s). This is a common rejection reason for coagulation studies where the citrate ratio is critical, or when multiple tests are ordered but insufficient blood was collected.
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Q10.A serum specimen appears cloudy and milky white. This is MOST consistent with:
A.Hemolysis from a traumatic drawB.Lipemia from a non-fasting patient or hyperlipidemiaC.Icterus due to elevated bilirubinD.Bacterial contaminationB. Lipemia from a non-fasting patient or hyperlipidemiaExplanation: A milky white, turbid appearance in serum is caused by lipemia — elevated lipids (triglycerides) suspended in the serum. This most commonly occurs in non-fasting patients or those with hyperlipidemia. Lipemia can interfere with photometric assays and may require ultracentrifugation or specimen dilution before testing.
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