Free Practice Questions for Phlebotomy

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Exam Review

Key Facts: Phlebotomy Exam

77.44%

2025 Pass Rate

NHA pass-rates report

390 (200-500)

Passing Score

Scaled score (200-500)

80-120 hrs

Study Time

Including training

28%

Routine Blood Collections

Largest domain

$134

Exam Fee

NHA store (Oct 2026)

2 years

Certification Valid

10 CE credits to renew

The NHA CPT phlebotomy exam has 120 questions (100 scored + 20 pretest) with a 2-hour time limit. The exam application costs $134 on the NHA store, and you test at your school, a PSI testing center or by live remote proctoring. Certification is valid for 2 years, and renewal requires 10 continuing education (CE) credits. Routine Blood Collections (28%) is the largest domain, followed by Safety and Compliance (26%), Patient Preparation (20%), Processing (14%), and Special Collections (12%).

Sample Phlebotomy Practice Questions

Try these sample questions to review concepts for the Phlebotomy exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 143+ question experience with AI tutoring.

1A phlebotomist needs to draw blood for a CBC, a BMP, and coagulation studies. Which tube should be filled FIRST?

A.Lavender-top tube (EDTA)

B.Light blue-top tube (sodium citrate)

C.Green-top tube (heparin) for the metabolic panel

D.Gray-top tube (sodium fluoride)

Explanation: According to the standard order of draw, the light blue-top tube (sodium citrate) for coagulation studies is drawn after blood culture bottles but before other additive tubes. The correct venipuncture order is: blood cultures, light blue (citrate), red/SST, green (heparin), lavender (EDTA), then gray (oxalate/fluoride). Drawing out of order can cause cross-contamination of additives between tubes, leading to inaccurate results.

2Which vein is the FIRST choice for routine venipuncture in an adult patient?

A.Cephalic vein

B.Basilic vein

C.Median cubital vein

D.Accessory cephalic vein

Explanation: The median cubital vein is the preferred first-choice vein for routine venipuncture because it is large, well-anchored, and located in the antecubital fossa where it is easily accessible. It is also less likely to roll and is further from nerves and arteries than the basilic vein, making it the safest choice for most patients.

3A phlebotomist selects a 21-gauge needle for a routine venipuncture. What does the gauge number indicate about the needle?

A.A 21-gauge needle has a larger bore than a 23-gauge needle

B.A 21-gauge needle has a smaller bore than a 23-gauge needle

C.A 21-gauge needle is longer than a 23-gauge needle

D.The gauge number refers to the length of the bevel

Explanation: In the needle gauge system, a lower gauge number indicates a larger needle bore (internal diameter). A 21-gauge needle has a larger opening than a 23-gauge needle, which means it allows faster blood flow and is standard for routine venipuncture. The 23-gauge is typically used for butterfly sets on smaller or more fragile veins.

4During venipuncture, the phlebotomist should insert the needle at what angle relative to the skin?

A.5 to 10 degrees

B.15 to 30 degrees

C.45 to 60 degrees

D.75 to 90 degrees

Explanation: The recommended insertion angle for venipuncture is 15 to 30 degrees with the bevel facing up. An angle less than 15 degrees may cause the needle to enter the skin superficially without penetrating the vein, while an angle greater than 30 degrees increases the risk of going through the vein entirely (transfixation), causing a hematoma.

5A patient complains of sharp, radiating pain shooting down the arm immediately after needle insertion. What should the phlebotomist do?

A.Redirect the needle slightly to find the vein

B.Remove the needle immediately and apply pressure

C.Ask the patient to relax and continue the draw

D.Apply the tourniquet tighter to stabilize the vein

Explanation: Sharp, shooting, or radiating pain during venipuncture indicates possible nerve involvement. The phlebotomist must immediately discontinue the procedure, remove the needle, and apply pressure. Continuing to probe or redirect could cause permanent nerve damage. The incident should be documented and the draw attempted at a different site.

6What is the maximum recommended time a tourniquet should remain on a patient during venipuncture?

A.30 seconds

B.1 minute

C.3 minutes

D.5 minutes

Explanation: A tourniquet should not remain on the arm for more than 1 minute. Prolonged tourniquet application causes hemoconcentration, where fluid leaks from blood vessels into surrounding tissues, artificially increasing the concentration of large molecules like proteins, lipids, and cell counts. This leads to falsely elevated lab results and can also cause patient discomfort and petechiae.

7A phlebotomist is drawing a light blue-top tube for PT/INR testing. What is the critical fill requirement for this tube?

A.Fill to at least 50% capacity

B.Fill completely to the line - a 9:1 blood-to-anticoagulant ratio is required

C.Overfill slightly to ensure adequate sample

D.Any amount of blood is acceptable if clotting is prevented

Explanation: Light blue-top tubes contain sodium citrate and must be filled to the exact fill line to maintain the critical 9:1 ratio of blood to anticoagulant. An underfilled tube will have excess citrate relative to the blood, falsely prolonging clotting times (PT/INR, PTT). The lab will reject an underfilled citrate tube because the results would be unreliable.

8Which tube additive works by chelating (binding) calcium to prevent clotting?

A.Heparin (green-top tube)

B.EDTA (lavender-top tube)

C.Sodium fluoride (gray-top tube)

D.Silica particles (red-top SST tube)

Explanation: EDTA (ethylenediaminetetraacetic acid) in the lavender-top tube prevents clotting by chelating (binding and removing) calcium ions from the blood. Calcium is essential for the coagulation cascade, so removing it stops clotting. In contrast, heparin works differently - it inhibits thrombin, an enzyme in the clotting pathway, rather than binding calcium.

9A patient has an IV line running in the left arm. The phlebotomist should:

A.Draw from the left arm below the IV site

B.Draw from the right arm using the preferred site

C.Turn off the IV for 2 minutes, then draw from the left arm

D.Draw from the left hand on the same side as the IV

Explanation: The opposite arm is preferred because an active infusion can dilute or contaminate a specimen collected from the IV arm. If no suitable opposite-arm site exists, the collector must follow the laboratory and facility procedure and coordinate with authorized clinical staff; the procedure may specify pausing the infusion, choosing an approved site away from the IV, documenting the collection, or using another method. There is no universal two-minute pause and 5 mL discard rule for every device, test, and facility.

10The basilic vein is generally the LAST choice for venipuncture because:

A.It is too small for standard needles

B.It is located near the brachial artery and median nerve

C.It does not contain enough blood volume

D.It collapses more easily than other veins

Explanation: The basilic vein is the least preferred venipuncture site because it runs close to the brachial artery and the median nerve on the inner (medial) aspect of the antecubital fossa. Accidental puncture of the brachial artery can cause significant bleeding, and nerve injury can lead to pain, numbness, or permanent damage. The preferred order is: median cubital (first), cephalic (second), basilic (last resort).

About the Phlebotomy Exam

The NHA Certified Phlebotomy Technician (CPT) exam certifies competency in blood collection, specimen handling, and patient care. Routine Blood Collections is the largest test-plan domain at 28% of scored items.

Exam sponsor: NHA (school sites, PSI testing centers, live remote proctoring). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

120 questions

Time Limit

2 hours

Passing Score

Scaled score 390 (200-500 scale)

Exam / Certification Fees

$134 exam application

Exam sponsor website

Reported exam pass rate: 77.44%. all CPT exams in 2025 (NHA, 66,002 exams) This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

28%

Routine Blood Collections

Equipment, tourniquet, site selection, venipuncture and dermal puncture, order of draw, tube mixing, complications, labeling

26%

Safety and Compliance

OSHA and NIOSH workplace safety, HIPAA, sharps and exposure control, standard and transmission-based precautions, PPE, quality control

20%

Patient Preparation

Requisitions, patient identification, consent, fasting and other test requirements, positioning, site selection

14%

Processing

Centrifuging and aliquoting, specimen integrity (temperature, light, time), chain of custody, critical values, re-collection

12%

Special Collections

Blood cultures, line draws, newborn screening, blood donation, point-of-care testing, tolerance tests, blood alcohol and drug screens

Preparing for the Phlebotomy Exam

What You Need to Know

Passing score: Scaled score 390 (200-500 scale)
Exam length: 120 questions
Time limit: 2 hours
Exam / certification fees: $134 exam application Official sources

Using Our Practice Resources

Work through all 143 available questions
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Phlebotomy: Suggested Study Strategy

1Memorize the order of draw and tube additives — this is the most tested topic

2Know vein selection: median cubital (primary), cephalic (secondary), basilic (avoid if possible — near brachial artery)

3Venipuncture technique: 15-30° angle, bevel up, tourniquet max 1 minute

4Capillary puncture sites: finger pad (middle or ring finger) for adults and older children, heel for newborns and young infants who are not yet walking

5PPE donning: gown → mask → eye protection → gloves (LAST); doffing: gloves FIRST

6Specimens must be labeled at the bedside before leaving the patient

Frequently Asked Questions

What is the phlebotomy CPT pass rate?

NHA reports that 77.44% of the 66,002 CPT exams administered in 2025 were passed (NHA annual pass-rates report). The exam has 120 questions (100 scored, 20 pretest). Results from PSI test centers and live remote proctoring post to your NHA account within 48 hours; exams taken at your school show preliminary results immediately.

How many questions are on the NHA CPT exam?

The NHA CPT phlebotomy exam has 120 total questions: 100 scored and 20 unscored pretest questions. You have 2 hours (120 minutes). All questions are multiple-choice and cover five test-plan domains: Safety and Compliance, Patient Preparation, Routine Blood Collections, Special Collections, and Processing.

How hard is the phlebotomy exam?

The NHA CPT exam is considered moderately difficult. Routine Blood Collections (28%) is the largest domain. You must know the order of draw, tube additives, vein selection, and complication management. With 80-120 hours (OEP estimate) of study and hands-on training, most candidates pass.

What is the order of draw?

The standard order of draw for evacuated tubes is: Blood cultures (yellow/sterile), Light blue (sodium citrate), Red/SST (no additive/gel), Green (heparin), Lavender (EDTA), Gray (sodium fluoride/potassium oxalate). This order prevents additive cross-contamination between tubes.

How long should I study for the phlebotomy exam?

Plan for 80-120 hours (OEP estimate) of combined classroom and self-study. Prioritize Routine Blood Collections (28%) — memorize order of draw, tube colors/additives, and needle gauges. Practice specimen labeling requirements and transport conditions. Aim for 80%+ on practice tests.

Free Practice Questions for Phlebotomy

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