Certified Phlebotomy Technician Exam Basic 3 — Questions and Answers
Question 1: Which of the following is a symptom of a vasovagal reaction during phlebotomy?
- Hypertension and flushing
- Pallor, diaphoresis, and loss of consciousness (Correct answer)
- Localized redness at the puncture site
- Rapid, bounding pulse
Correct answer: Pallor, diaphoresis, and loss of consciousness
Vasovagal syncope presents with pallor, sweating, nausea, bradycardia, and possible fainting due to a sudden drop in blood pressure.
Question 2: What does 'CLSI' stand for and why is it important in phlebotomy?
- Clinical Laboratory Standards Institute — sets standards for laboratory procedures (Correct answer)
- Certified Laboratory Safety Inspector — oversees facility inspections
- Clinical Licensing and Specimen Integrity — governs specimen transport
- Central Laboratory Systems Integration — manages LIS software
Correct answer: Clinical Laboratory Standards Institute — sets standards for laboratory procedures
CLSI (Clinical Laboratory Standards Institute) publishes evidence-based guidelines, including H3-A6 for venipuncture, that standardize phlebotomy practices nationwide.
Question 3: A phlebotomist is collecting blood cultures. What is the correct skin preparation sequence?
- Isopropyl alcohol alone
- Povidone-iodine alone for 60 seconds
- Chlorhexidine gluconate (or iodine tincture) scrub after alcohol, allowed to dry completely (Correct answer)
- Betadine applied and immediately wiped off with alcohol
Correct answer: Chlorhexidine gluconate (or iodine tincture) scrub after alcohol, allowed to dry completely
Blood culture skin prep requires a two-step process — alcohol followed by chlorhexidine or iodine — with full dry time to minimize contamination.
Question 4: What is the primary purpose of inverting a collection tube after drawing blood?
- To prevent the needle from clogging
- To mix the blood with the tube additive thoroughly (Correct answer)
- To activate clotting for serum separation
- To label the tube by noting the draw order
Correct answer: To mix the blood with the tube additive thoroughly
Gentle inversion (typically 3–8 times depending on tube type) ensures the blood mixes completely with the additive to achieve the intended anticoagulant or preservative effect.
Question 5: Which condition makes the antecubital fossa an unsuitable venipuncture site?
- Well-visible, non-dominant arm veins
- Presence of an arteriovenous (AV) fistula for dialysis (Correct answer)
- Mild scarring from a previous draw
- Slight hair follicles over the area
Correct answer: Presence of an arteriovenous (AV) fistula for dialysis
An AV fistula is a surgically created connection for dialysis; drawing blood from that arm risks fistula damage, infection, and inaccurate results.
Question 6: What is 'reflux' in the context of phlebotomy and how is it prevented?
- Backflow of tube additive into the patient's vein; prevented by keeping the arm angled down and the tube below the vein (Correct answer)
- Excess blood entering the tube; prevented by using a smaller gauge needle
- Leakage of blood from around the needle; prevented by applying firmer pressure
- Air entering the tube; prevented by capping immediately after draw
Correct answer: Backflow of tube additive into the patient's vein; prevented by keeping the arm angled down and the tube below the vein
Reflux occurs when additive flows back from the tube into the patient's vein; keeping the arm slightly downward during collection prevents this.
Question 7: Which federal agency requires healthcare workers to follow Standard Precautions to prevent bloodborne pathogen transmission?
- CDC
- FDA
- OSHA (Correct answer)
- CMS
Correct answer: OSHA
OSHA's Bloodborne Pathogen Standard (29 CFR 1910.1030) mandates Standard Precautions, including PPE use and safe needle handling, for all healthcare workers.
Certified Phlebotomy Technician Exam Basic 3
Which of the following is a symptom of a vasovagal reaction during phlebotomy?