A phlebotomist must collect a blood culture set, a PT/INR, a basic metabolic panel on a gel serum tube, and a CBC. Which collection sequence follows the standard order of draw?

Blood culture, light blue, gel serum tube, lavender

Light blue, blood culture, lavender, gel serum tube

Gel serum tube, blood culture, light blue, lavender

Lavender, light blue, blood culture, gel serum tube

A phlebotomist has attempted venipuncture twice on the same patient without obtaining blood. What is the correct next step?

Stop and ask another qualified phlebotomist to attempt the draw

Attempt a third and fourth time on the same arm

Probe laterally with the needle already in place until blood appears

Send the patient home and cancel the tests

A neonatal bilirubin is collected. How must the specimen be handled during transport?

Protected from light, for example with an amber tube or foil wrap

Kept in an ice slurry for at least 30 minutes

Left uncovered at room temperature to allow clotting

Frozen immediately at minus 20 degrees Celsius

Which description of antecubital vein anatomy is correct?

The cephalic vein lies laterally and the basilic vein medially, with the median cubital between them

The median cubital vein lies deep to the brachial artery

The basilic vein lies on the lateral or thumb side of the arm

The cephalic vein lies on the medial or little finger side

A serum glucose is collected in a gold gel tube and sits uncentrifuged at room temperature for three hours before testing. What happens to the glucose result?

It falls, because the blood cells keep metabolising glucose until the serum is separated

It rises, because the clot continues to release stored glucose into the serum

It is unchanged, because the gel barrier blocks all cell metabolism from the moment of collection

It becomes unreportable, because glucose degrades into a compound the analyser misreads

A phlebotomist is asked to collect blood from a patient who is having a seizure at the moment of arrival. What is the correct action?

Do not attempt the draw; get help, protect the patient from injury and return when it is safe

Draw quickly from the arm that is moving least, because a stat order cannot be delayed for any reason

Hold the patient's arm firmly still with the help of a colleague and complete the collection

Place a padded tongue blade between the teeth first, then decide whether the draw can proceed

When does the timing clock start for the specimens of a two-hour glucose tolerance test?

When the patient swallows the last of the glucose solution she was given

When the fasting specimen is collected, since that is the first sample in the whole series

When the patient arrives at the laboratory and is registered for the appointment that morning

When the patient begins to drink, because the first mouthful is already being absorbed

A phlebotomist draws blood into a syringe and then fills a citrate tube, a heparin tube and an EDTA tube. In what order should the tubes be filled?

Citrate, then heparin, then EDTA, which is the same relative order as an evacuated tube draw

EDTA first, because the cells begin to clot in the syringe and the count is the most fragile result

Heparin first, then citrate, then EDTA, because heparin is the least affected by any delay

Any order, since the blood is already mixed in the barrel and no carryover can occur

A phlebotomist arrives to draw an inpatient and finds the physician examining the patient. What should be done?

Leave, return when the examination is finished, and inform the nurse if the draw is timed

Enter quietly and draw the blood while the physician works on the opposite side of the bed

Ask the physician to step out of the room so that the timed collection can be completed

Cancel the order and let the ordering provider know that the specimen could not be obtained

Why should a phlebotomist ask a patient about previous reactions before starting a draw?

So syncope, latex allergy and a difficult access history can be planned for in advance

So the results can be compared with the patient's reaction at the previous appointment

So the phlebotomist can decide whether the patient is exaggerating the difficulty of the draw

So the laboratory can add a comment about the patient's anxiety to the printed report

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Certified Phlebotomy Technician (CPT) Certification Examination — Exam facts
Administering body	National Healthcareer Association (NHA) — exam delivered by a PSI testing center, a live remote proctoring provider, or the candidate's own school or employer Source: NHA — Candidate Handbook (PDF, updated 06/01/2026)
Questions	120 questions (100 scored, 20 unscored pretest) Source: NHA — Test Plan for the Certified Phlebotomy Technician (CPT) Exam (2024 job analysis, PDF)
Time limit	120 minutes Source: NHA — Test Plan for the Certified Phlebotomy Technician (CPT) Exam (2024 job analysis, PDF)
Passing score	Scaled score of 390 on a 200–500 scale Source: NHA — Candidate Handbook (PDF, updated 06/01/2026)
Fees	$134 — Examination application (National Healthcareer Association, per attempt) $195 — Recertification (National Healthcareer Association, every two years) Source: NHA store — Certified Phlebotomy Technician (CPT) Exam Application
Languages offered	English Source: NHA — Candidate Handbook (PDF, updated 06/01/2026)

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1. Collection Procedures
A phlebotomist must collect a blood culture set, a PT/INR, a basic metabolic panel on a gel serum tube, and a CBC. Which collection sequence follows the standard order of draw?
- a.Blood culture, light blue, gel serum tube, lavender
- b.Light blue, blood culture, lavender, gel serum tube
- c.Gel serum tube, blood culture, light blue, lavender
- d.Lavender, light blue, blood culture, gel serum tube
Answer: a
Explanation: The standard order of draw is blood culture (sterile) first, then the light blue sodium citrate coagulation tube, then serum tubes with or without gel, then heparin, then EDTA, then glycolytic inhibitor tubes. Drawing the blood culture first protects it from skin-flora contamination introduced by non-sterile tube handling. Every other sequence listed allows additive carryover into a tube where that additive causes error, most notably EDTA carried into a chemistry or coagulation tube.
Source: CLSI GP41
2. Collection Procedures
A phlebotomist has attempted venipuncture twice on the same patient without obtaining blood. What is the correct next step?
- a.Attempt a third and fourth time on the same arm
- b.Stop and ask another qualified phlebotomist to attempt the draw
- c.Probe laterally with the needle already in place until blood appears
- d.Send the patient home and cancel the tests
Answer: b
Explanation: Standard practice limits a phlebotomist to two attempts before handing the patient to another qualified collector, which protects the patient from repeated trauma. Blind lateral probing risks nerve damage and arterial puncture and is never acceptable. Canceling ordered tests without escalation deprives the provider of needed results.
Source: CLSI GP41
3. Specimen Handling
A neonatal bilirubin is collected. How must the specimen be handled during transport?
- a.Protected from light, for example with an amber tube or foil wrap
- b.Kept in an ice slurry for at least 30 minutes
- c.Left uncovered at room temperature to allow clotting
- d.Frozen immediately at minus 20 degrees Celsius
Answer: a
Explanation: Bilirubin is photosensitive and degrades within minutes of light exposure, so an amber microtube or foil wrapping is used. Vitamin B12, folate, carotene and vitamin A require the same protection. Freezing whole blood hemolyzes it, chilling is not the required protection here, and leaving the tube exposed causes falsely low results.
Source: CLSI GP44
4. Anatomy & Terminology
Which description of antecubital vein anatomy is correct?
- a.The median cubital vein lies deep to the brachial artery
- b.The basilic vein lies on the lateral or thumb side of the arm
- c.The cephalic vein lies on the medial or little finger side
- d.The cephalic vein lies laterally and the basilic vein medially, with the median cubital between them
Answer: d
Explanation: In the antecubital fossa the cephalic vein runs along the lateral thumb side, the basilic vein along the medial little finger side, and the median cubital connects them across the middle. The median cubital is superficial and lies above, not beneath, the brachial artery. Reversing the cephalic and basilic positions would put the phlebotomist next to the artery and nerve without realizing it.
5. Collection Procedures
A serum glucose is collected in a gold gel tube and sits uncentrifuged at room temperature for three hours before testing. What happens to the glucose result?
- a.It rises, because the clot continues to release stored glucose into the serum
- b.It falls, because the blood cells keep metabolising glucose until the serum is separated
- c.It is unchanged, because the gel barrier blocks all cell metabolism from the moment of collection
- d.It becomes unreportable, because glucose degrades into a compound the analyser misreads
Answer: b
Explanation: Cells in contact with serum or plasma continue glycolysis, and glucose falls at a rate usually quoted as several percent per hour at room temperature. A three hour delay can turn a genuinely normal glucose into an apparently low one, or hide a real hyperglycemia. The remedy is to separate the serum within the laboratory's stated limit, or to collect into a gray fluoride tube. The gel does nothing until the tube is spun.
6. Collection Procedures
A phlebotomist is asked to collect blood from a patient who is having a seizure at the moment of arrival. What is the correct action?
- a.Draw quickly from the arm that is moving least, because a stat order cannot be delayed for any reason
- b.Do not attempt the draw; get help, protect the patient from injury and return when it is safe
- c.Hold the patient's arm firmly still with the help of a colleague and complete the collection
- d.Place a padded tongue blade between the teeth first, then decide whether the draw can proceed
Answer: b
Explanation: A needle must never be introduced into a moving limb, and no laboratory result is worth a nerve injury or a needlestick. The phlebotomist summons help, keeps the patient from striking nearby objects and does not restrain them, then returns once the seizure has ended and the nurse confirms it is safe. Putting anything into the mouth of a seizing patient is an outdated practice that causes injury.
7. Collection Procedures
When does the timing clock start for the specimens of a two-hour glucose tolerance test?
- a.When the fasting specimen is collected, since that is the first sample in the whole series
- b.When the patient arrives at the laboratory and is registered for the appointment that morning
- c.When the patient swallows the last of the glucose solution she was given
- d.When the patient begins to drink, because the first mouthful is already being absorbed
Answer: c
Explanation: The timed specimens are counted from the moment the patient swallows the last of the glucose load, which should be consumed within about five minutes. Starting the clock at the fasting draw or at registration shifts every subsequent specimen, and a glucose reported at the wrong interval can create or hide a diagnosis of diabetes. Exact collection times are documented on each tube.
8. Collection Procedures
A phlebotomist draws blood into a syringe and then fills a citrate tube, a heparin tube and an EDTA tube. In what order should the tubes be filled?
- a.Citrate, then heparin, then EDTA, which is the same relative order as an evacuated tube draw
- b.EDTA first, because the cells begin to clot in the syringe and the count is the most fragile result
- c.Heparin first, then citrate, then EDTA, because heparin is the least affected by any delay
- d.Any order, since the blood is already mixed in the barrel and no carryover can occur
Answer: a
Explanation: The blood in a syringe begins to clot from the moment it is drawn, so the coagulation tube is filled first and the transfer is completed quickly. The relative order of the tubes does not change with the collection method. Carryover is no longer the reason, but clot formation is, and it argues for the same sequence rather than a different one.
9. Patient Preparation
A phlebotomist arrives to draw an inpatient and finds the physician examining the patient. What should be done?
- a.Enter quietly and draw the blood while the physician works on the opposite side of the bed
- b.Leave, return when the examination is finished, and inform the nurse if the draw is timed
- c.Ask the physician to step out of the room so that the timed collection can be completed
- d.Cancel the order and let the ordering provider know that the specimen could not be obtained
Answer: b
Explanation: The examination is not interrupted, and the phlebotomist steps out and returns. If the draw is time critical, the nurse is told so the timing can be preserved or the order rescheduled. Working around a physician at the bedside risks the patient and contaminates the field, asking a physician to leave is not the phlebotomist's call, and cancelling is premature.
10. Patient Preparation
Why should a phlebotomist ask a patient about previous reactions before starting a draw?
- a.So the results can be compared with the patient's reaction at the previous appointment
- b.So the phlebotomist can decide whether the patient is exaggerating the difficulty of the draw
- c.So the laboratory can add a comment about the patient's anxiety to the printed report
- d.So syncope, latex allergy and a difficult access history can be planned for in advance
Answer: d
Explanation: Asking turns a surprise into a plan: a fainter is reclined, a latex allergy changes every item that touches the skin, and a history of difficult access changes the equipment and who performs the draw. None of it concerns the results themselves, and none of it is a judgement about whether the patient is exaggerating.

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