Free Phlebotomy Practice Test: 36 Questions With Answers and Explanations
By the OQMPS team ·
This free phlebotomy practice test has 36 questions covering the five areas of the National Healthcareer Association’s Certified Phlebotomy Technician (CPT) exam: safety and compliance, patient preparation, routine blood collection, special collections and processing. Pick an answer to see whether you are right, why, and the source behind it.
OQMPS is not affiliated with the NHA, and these are not real exam questions. They are written from the NHA’s published test plan and answered from the standards the exam is built on: OSHA, CDC, The Joint Commission and CLSI.
Phlebotomy practice test
The questions follow the exam’s weighting, so routine collection and safety get the most. Aim for 80% or better before you book.
0 of 36 answered
Question 1 · Safety and compliance
You have just finished a venipuncture. What should happen to the contaminated needle?
The answer is B. OSHA's Bloodborne Pathogens Standard says contaminated needles "shall not be bent, recapped, or removed" except in narrow, documented circumstances, and must be discarded immediately or as soon as feasible in a sharps container. Engaging the device's safety feature first is part of the procedure.
Question 2 · Safety and compliance
Which of these meets OSHA's requirements for a sharps container?
The answer is D. Under 29 CFR 1910.1030, sharps containers must be closable, puncture resistant, leakproof on sides and bottom, and labeled or color-coded. A bag or a cardboard box is not puncture resistant, and an unlabeled bin fails the labeling rule.
Question 3 · Safety and compliance
You are stuck by a used needle. What should you do first?
The answer is C. CDC's first steps after a needlestick: wash the puncture with soap and water and report the incident to your supervisor, then get a prompt medical evaluation. Every exposure is reported, whatever is known about the patient.
Question 4 · Safety and compliance
Your hands are not visibly soiled. What does CDC prefer for hand hygiene before you put on gloves?
The answer is A. CDC says alcohol-based hand sanitizer is preferred unless hands are visibly soiled, and that "gloves are not a substitute for hand hygiene": clean your hands before putting gloves on and after taking them off.
Question 5 · Safety and compliance
What does "universal precautions" mean?
The answer is C. OSHA defines universal precautions as an approach in which "all human blood and certain human body fluids are treated as if known to be infectious" for HIV, HBV and other bloodborne pathogens.
Question 6 · Safety and compliance
Where does OSHA require employers to record injuries from contaminated sharps?
The answer is D. The Bloodborne Pathogens Standard requires employers to "establish and maintain a sharps injury log for the recording of percutaneous injuries from contaminated sharps."
Question 7 · Safety and compliance
A patient becomes faint partway through a draw. What should you do?
The answer is A. Release the tourniquet, remove the needle as quickly as possible and apply pressure while the patient lowers their head, and lay them flat where practical. Notify first-aid trained staff. CLSI advises against ammonia inhalants because of their possible adverse effects.
Question 8 · Safety and compliance
Under OSHA's standard, when must you wash your hands after taking off gloves?
The answer is B. OSHA requires employers to ensure that employees "wash their hands immediately or as soon as feasible after removal of gloves." CDC adds that gloves are never a substitute for hand hygiene.
Question 9 · Safety and compliance
Why does CLSI recommend single-use tourniquets?
The answer is C. CLSI's 2017 standard recommends single-use tourniquets because of the prevalence of MRSA and other pathogens on previously used ones, to prevent healthcare-acquired infections.
Question 10 · Patient preparation
Which pair can be used to identify a patient before a blood draw?
The answer is B. The Joint Commission requires at least two patient identifiers when collecting blood and other specimens, and states that the patient's room number or physical location is not used as an identifier.
Question 11 · Patient preparation
When should blood tubes be labeled?
The answer is D. The Joint Commission requires containers for blood and other specimens to be labeled in the presence of the patient. CLSI also asks you to compare the label with the ID band or have an outpatient confirm it.
Question 12 · Patient preparation
A patient tells you they have fainted during blood draws before. What should you do?
The answer is C. Under CLSI's 2017 venipuncture standard, a patient with a history of fainting must be put into a recumbent or reclined position.
Question 13 · Patient preparation
A patient had a mastectomy on the left side six years ago. Where should you draw?
The answer is A. CLSI GP41 requires written physician permission for a venipuncture on the same side as a mastectomy, including a bilateral mastectomy, regardless of how long ago the surgery was.
Question 14 · Patient preparation
Which antecubital veins does CLSI say to try first?
The answer is D. CLSI's order of preference is the median veins first, then the lateral (cephalic) veins, then the medial (basilic) veins.
Question 15 · Patient preparation
Which tube is used for a complete blood count (CBC)?
The answer is B. VCU Health's guide lists the CBC, with or without differential, in the purple (lavender) K2EDTA tube. EDTA prevents clotting and preserves the cells for counting.
Question 16 · Patient preparation
Which tube is used for a PT/INR?
The answer is A. Coagulation tests such as PT/INR and aPTT go in the blue sodium citrate tube, VCU Health's guide shows.
Question 17 · Routine blood collection
How long can the tourniquet stay on before you access the vein?
The answer is C. CLSI GP41 says tourniquet application must not exceed one minute before accessing the vein, to prevent hemoconcentration.
Question 18 · Routine blood collection
How should the site be cleaned for a routine venipuncture?
The answer is B. CLSI's 2017 standard keeps 70% isopropyl alcohol as the antiseptic of choice, applied with friction (back and forth rather than the old concentric circles), and the site must air dry before the venipuncture.
Question 19 · Routine blood collection
Where should you anchor the vein?
The answer is A. Anchor below the insertion site, not above it, which also reduces the risk of an accidental needlestick.
Question 20 · Routine blood collection
Should the patient pump their fist to make the vein stand out?
The answer is D. Permitting the patient to pump their fist appears on the American Certification Agency's list of the top ten errors in a basic venipuncture, based on CLSI's standard.
Question 21 · Routine blood collection
You need a gold (SST), a lavender (EDTA), a gray (fluoride) and a light blue (citrate) tube. Which do you draw first?
The answer is D. The CLSI order of draw is blood cultures, light blue (citrate), serum tubes such as gold, green (heparin), lavender (EDTA), then gray (fluoride). See our full order of draw guide.
Question 22 · Routine blood collection
How many times should a lavender EDTA tube be inverted after filling?
The answer is A. BD's chart gives 8 to 10 gentle inversions for EDTA tubes. Three to four is the figure for citrate tubes and five for serum tubes. Never shake a tube.
Question 23 · Routine blood collection
You are using a butterfly, and a light blue tube is the first tube you need. What do you do?
The answer is C. The butterfly's tubing holds air that would underfill the citrate tube and upset its blood-to-additive ratio. BD says to draw a discard tube first, a plain or another citrate tube, which does not need to be full.
Question 24 · Routine blood collection
Where should a fingerstick be done?
The answer is B. Akron Children's Hospital's procedure: just off the center of the finger pad of the third (middle) or fourth (ring) finger, avoiding the sides and the tip.
Question 25 · Routine blood collection
What do you do with the first drop of blood from a capillary puncture?
The answer is D. The first drop contains excess tissue fluid and must be wiped away. Avoid heavy squeezing too, which pushes more tissue fluid into the sample.
Question 26 · Routine blood collection
What must a blood tube label include, under CLSI?
The answer is C. CLSI GP41 requires the patient's first and last name, a patient-specific identifier, the collection date and time, and the identity of the person who collected the specimen.
Question 27 · Routine blood collection
After cleaning the site, you need to feel the vein again. What should you do?
The answer is B. Under CLSI's 2017 standard, if you need to re-palpate after cleaning, the gloved finger must also be cleaned with alcohol so it does not contaminate the site. Re-palpating with an uncleaned glove is on ACA's list of common venipuncture errors.
Question 28 · Special collections
In a multi-tube draw, when are blood cultures collected?
The answer is B. Blood cultures are always drawn before other tubes, to reduce contamination, as VCU Health's guide puts it.
Question 29 · Special collections
What is the site usually cleaned with for a legal blood alcohol specimen?
The answer is A. Forensic protocols call for a non-alcoholic antiseptic so the prep cannot add alcohol to the sample. Hawaii's rule, for example, specifies a non-alcoholic aqueous antiseptic such as benzalkonium chloride or povidone-iodine. Follow the protocol of the agency or lab that will test it.
Question 30 · Special collections
Where should an infant heel stick be done?
The answer is D. Heel punctures are performed on the lateral or medial plantar surface of the foot, avoiding the arch and the posterior curvature of the heel.
Question 31 · Special collections
When should a 25-gauge needle be used to collect blood?
The answer is C. A 2006 study found more variability in potassium results with 25-gauge needles, and its authors concluded they "cannot be universally recommended" and should be reserved for patients with problematic venous access and newborns.
Question 32 · Processing
How long should a BD SST serum tube clot before it is centrifuged?
The answer is D. BD's SST tube requires a minimum clotting time of 30 minutes before centrifugation, and patients on anticoagulants may take longer. (Five minutes is the figure for BD's thrombin-based rapid serum tube, a different product.)
Question 33 · Processing
What special handling does a bilirubin specimen need?
The answer is B. Light breaks bilirubin down, so labs ask for an amber vial or a plastic vial wrapped in foil.
Question 34 · Processing
An ammonia level is collected in a green (sodium heparin) tube. How is it transported?
The answer is C. VCU Health's guide lists ammonia in the green sodium heparin tube with the instruction "transport on ice."
Question 35 · Processing
Which tube contains an additive that stops cells using up glucose, and is used for fasting and timed glucose?
The answer is A. The gray tube's sodium fluoride is a glycolytic inhibitor. VCU Health's guide lists fasting and timed glucose, lactate and blood alcohol in it.
Question 36 · Processing
A light blue citrate tube reaches the lab only half full. What is the likely outcome?
The answer is D. Coagulation results depend on the ratio of blood to citrate. UCHealth's procedure, for example: "Partially filled blue top tubes will be rejected."
How the real CPT exam works
According to the NHA’s 2025 test plan, the CPT exam has 100 scored questions and 20 unscored pretest questions, and you have two hours. The scored questions are split across five domains:
| Domain | Scored questions | In this practice test |
|---|---|---|
| Safety and compliance | 26 | 9 |
| Patient preparation | 20 | 7 |
| Routine blood collection | 28 | 11 |
| Special collections | 12 | 4 |
| Processing | 14 | 5 |
To sit the exam through the training route, the NHA asks for a high school diploma or GED, a phlebotomy training program completed within the last five years, and evidence of at least 30 venipunctures and 10 capillary or finger sticks on live individuals. The certification is renewed every two years with 10 continuing education credits.
How to study for the phlebotomy exam
- Learn the order of draw cold. It shows up across domains: tube colors, additives, inversions and the capillary order. Our order of draw guide has a chart.
- Know the numbers. One minute for the tourniquet, two patient identifiers, 8 to 10 inversions for EDTA, 30 minutes for a serum tube to clot.
- Read the safety rules at the source. A quarter of the exam is safety and compliance, and OSHA’s Bloodborne Pathogens Standard answers much of it.
- Practice on people. The live venipunctures and finger sticks the NHA asks for are also how the steps become automatic.
- Know what to expect. See what to expect on the phlebotomy certification exam.
Answer key
For a quick check, or if you took the test on paper:
- B. Activate the safety feature and discard it at once in a sharps container
- D. A closable, puncture-resistant, leakproof, labeled container
- C. Wash it with soap and water and report it to your supervisor
- A. Alcohol-based hand sanitizer
- C. Treating all blood and certain body fluids as if known to be infectious
- D. In a sharps injury log
- A. Release the tourniquet, remove the needle, apply pressure and lower their head
- B. Immediately, or as soon as feasible
- C. Reused tourniquets can carry MRSA and other pathogens
- B. Full name and date of birth
- D. In the patient's presence, right after collection
- C. Draw with the patient lying down or reclined
- A. The right arm; the mastectomy side needs written physician permission
- D. The median veins, in the center of the arm
- B. Lavender (EDTA)
- A. Light blue (sodium citrate)
- C. No more than 1 minute
- B. 70% isopropyl alcohol, with friction, left to air dry
- A. Below the insertion site
- D. No; fist pumping is a recognized venipuncture error
- D. Light blue
- A. 8 to 10 times
- C. Draw a discard tube first to fill the tubing
- B. Just off center of the middle or ring finger pad
- D. Wipe it away; it contains excess tissue fluid
- C. Full name, a unique identifier, collection date and time, and who collected it
- B. Clean your gloved fingertip with alcohol first
- B. First, before any other tube
- A. A non-alcoholic antiseptic, such as povidone-iodine
- D. On the medial or lateral plantar surface of the heel
- C. For newborns and patients with very difficult veins
- D. At least 30 minutes
- B. Protection from light
- C. On ice
- A. Gray (sodium fluoride)
- D. It is rejected and the patient is redrawn
Get certified with OQMPS
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Frequently asked questions
How many questions are on the NHA phlebotomy exam?
The NHA's 2025 test plan lists 100 scored questions and 20 unscored pretest questions, with two hours to finish.
What topics does the phlebotomy certification exam cover?
Five domains: safety and compliance (26 scored questions), patient preparation (20), routine blood collections (28), special collections (12) and processing (14).
What do I need to take the NHA CPT exam?
Through the training route: a high school diploma or GED, a phlebotomy training program completed within the last five years, and evidence of at least 30 venipunctures and 10 capillary or finger sticks on live individuals.
Are these real NHA exam questions?
No. OQMPS is not affiliated with the NHA. The questions are written from the NHA's published test plan and answered from the standards the exam draws on, with a source for each.
What is a good score on a phlebotomy practice test?
Treat 80% or better, consistently, as a sign you are ready to book. Review the explanation for every question you miss, not just the score.
Sources
- NHA, Certified Phlebotomy Technician (CPT) Test Plan, 2025
- NHA, Certified Phlebotomy Technician (CPT)
- OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030
- CDC, Clinical Safety: Hand Hygiene for Healthcare Workers
- CDC/NIOSH, Bloodborne Infectious Diseases: Risk Factors
- The Joint Commission, National Patient Safety Goals (hospital program)
- ACA, New CLSI Venipuncture Guidelines (summary of CLSI GP41, 7th ed.)
- CAP Today Q&A on fainting during venipuncture (citing CLSI)
- BD Vacutainer Order of Draw for Multiple Tube Collections
- VCU Health Department of Pathology, Order of Draw (rev. 2/2025)
- UCHealth, Order of Draw procedure SC003.1
- Akron Children's Hospital Laboratory, Performing a Capillary Puncture
- Hawaii Administrative Rules § 11-114-23, Sample collection procedures
- Lippi et al., Influence of the needle bore size used for collecting venous blood samples, Clin Chem Lab Med (2006)
- Kocijancic et al., Biochemia Medica (2014), on BD SST clotting time
- Geisinger Medical Laboratories, Bilirubin, Fractionated