Certified Phlebotomy Technician Exam Basic 2 — Questions and Answers
Question 1: Which gauge needle is most commonly used for routine venipuncture in adults?
- 18 gauge
- 21 gauge (Correct answer)
- 23 gauge
- 25 gauge
Correct answer: 21 gauge
A 21-gauge needle is the standard choice for routine adult venipuncture, balancing flow rate and patient comfort.
Question 2: What does the term 'hemoconcentration' refer to in phlebotomy?
- Dilution of blood due to excessive fluid intake
- Increased concentration of blood cells due to prolonged tourniquet use (Correct answer)
- Clotting of blood within the collection tube
- Hemolysis caused by improper needle insertion
Correct answer: Increased concentration of blood cells due to prolonged tourniquet use
Hemoconcentration occurs when a tourniquet is left on too long, causing fluid to shift out of capillaries and artificially elevating cell and analyte concentrations.
Question 3: Which tube additive is found in a red-top (no additive) tube?
- EDTA
- Sodium citrate
- Heparin
- None — it contains no additive (Correct answer)
Correct answer: None — it contains no additive
A plain red-top tube contains no additive; blood clots naturally and serum is obtained after centrifugation.
Question 4: A patient's arm shows petechiae after tourniquet application. What does this finding suggest?
- Normal skin response to pressure
- Possible platelet or coagulation disorder (Correct answer)
- Allergic reaction to latex gloves
- Venous thrombosis at the draw site
Correct answer: Possible platelet or coagulation disorder
Petechiae (small pinpoint hemorrhages) under a tourniquet may indicate a platelet disorder or capillary fragility and should be reported.
Question 5: What is the correct action if a phlebotomist accidentally needlesticks themselves during a draw?
- Apply a bandage and continue the procedure
- Immediately wash the site, report to supervisor, and follow exposure protocol (Correct answer)
- Squeeze the wound to remove any contaminated blood
- Apply antiseptic and monitor for symptoms over 24 hours
Correct answer: Immediately wash the site, report to supervisor, and follow exposure protocol
Immediate washing, reporting, and following the facility's exposure control plan are required by OSHA bloodborne pathogen standards.
Question 6: Which anticoagulant is present in a light-blue top tube and what test is it primarily used for?
- EDTA — complete blood count
- Sodium citrate — coagulation studies (Correct answer)
- Lithium heparin — chemistry panels
- Potassium oxalate — glucose testing
Correct answer: Sodium citrate — coagulation studies
Light-blue top tubes contain sodium citrate (3.2%) which chelates calcium to prevent clotting, making them ideal for PT, aPTT, and other coagulation tests.
Question 7: When performing a capillary puncture on an infant's heel, which area should be avoided?
- The outer lateral plantar surface
- The medial and posterior curvature of the heel (Correct answer)
- The great toe pad
- The inner lateral plantar surface
Correct answer: The medial and posterior curvature of the heel
The posterior curvature of the infant heel is avoided because the calcaneus (heel bone) is very close to the surface there, risking bone puncture and osteomyelitis.
Certified Phlebotomy Technician Exam Basic 2
Which gauge needle is most commonly used for routine venipuncture in adults?