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Quizzes > Health & Medicine > Human Anatomy & Medicine

Test Your Phlebotomy Knowledge with Our Quiz!

Think you know blood donation needles are which of the following gauges? Take the quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art scene of blood draw tools needles gauge vials gloves on golden yellow background for phlebotomy quiz

Ready to elevate your skills? Take our free phlebotomy quiz to test your knowledge on blood draw needle gauge questions and master every technique. In this Ultimate Phlebotomy Quiz: Master Needle Gauge & Techniques, you'll tackle realistic phlebotomy exam practice questions and reinforce what you know about phlebotomy needle gauges . Track your progress, identify strengths and areas to review - even the trickiest safety protocols become second nature. Whether you're studying for a phlebotomy certification test or feeding your curiosity with a fun phlebotomy trivia quiz, you'll learn critical procedures - from identifying which blood donation needles are which of the following gauges to ensuring patient comfort. Dive in, challenge yourself, and start your journey toward needle-sharp proficiency with our phlebotomy quiz now!

What is the recommended patient identification procedure before drawing blood?
Confirm the name on the requisition without asking the patient
Check the patient's wristband only
Ask the patient for their room number
Ask the patient to state full name and date of birth and compare with the requisition
Verifying two unique identifiers (name and date of birth) at bedside ensures accurate patient identification before specimen collection, reducing the risk of sample mislabeling and medical errors. Always compare patient-provided information against the requisition. CDC Patient ID
What is the proper hand hygiene step before performing a venipuncture?
Wash hands with soap and water or use an alcohol-based hand rub
Skip hand hygiene if wearing gloves
Don gloves without washing hands
Apply hand sanitizer only after drawing blood
Hand hygiene using soap and water or an alcohol-based rub before donning gloves significantly reduces the risk of transmitting pathogens between patients. It is critical even when gloves are used. WHO Hand Hygiene
At what angle should you insert the needle for a standard antecubital venipuncture?
45 - 60 degrees
5 - 10 degrees
90 degrees
15 - 30 degrees
A 15 - 30° insertion angle allows the bevel to enter the vein lumen smoothly without puncturing through the far wall. Shallower angles reduce the risk of overshooting and causing hematoma. CLSI Venipuncture
Which anticoagulant is found in lavender-top tubes?
Sodium citrate
Potassium oxalate
Heparin
Ethylenediaminetetraacetic acid (EDTA)
Lavender-top tubes contain EDTA, which chelates calcium and prevents clotting by inhibiting coagulation enzymes. This preserves cellular morphology for hematology testing. NCBI Tube Additives
What is the maximum recommended time to leave a tourniquet on a patient's arm before venipuncture?
2 minutes
1 minute
10 minutes
5 minutes
Leaving a tourniquet on longer than one minute can cause hemoconcentration, altered analyte levels, and patient discomfort. Release the tourniquet as soon as blood flow is established. CLSI Guidelines
Which needle gauge is most commonly used for routine adult venipuncture?
23 gauge
21 gauge
25 gauge
18 gauge
A 21-gauge needle balances patient comfort with efficient blood flow and minimal hemolysis, making it the most common for routine adult draws. Larger needles may cause bruising; smaller needles can slow collection. Lab Quality Confab
What is the correct order of draw after a light-blue-top tube?
Green, Red, Gold (SST), Lavender, Gray
Gold (SST), Red, Green, Lavender, Gray
Lavender, Red, Gold (SST), Green, Gray
Red, Gold (SST), Green, Lavender, Gray
According to CLSI order of draw, after coagulation tubes (light blue) comes serum tubes (red or SST), followed by heparin (green), EDTA (lavender), and glycolysis inhibitors (gray), preventing cross-contamination of additives. CLSI Order of Draw
If the patient's vein rolls away during insertion, what is the best technique to stabilize it?
Anchor the vein firmly below the puncture site and try again
Withdraw and reinsert without anchoring
Use a larger needle to pin the vein
Ask the patient to make a fist repeatedly
Anchoring the vein below the insertion site prevents it from moving and reduces the risk of a failed stick or hematoma. Always hold the skin taut. Phlebotomy Today
Which vein is considered the safest and most preferred site for routine antecubital venipuncture?
Dorsal hand vein
Median cubital vein
Basilic vein
Cephalic vein
The median cubital vein is large, well-anchored, and less painful to access, making it the preferred site for routine blood draws. The basilic vein is close to nerves and arteries. NCBI Venipuncture Sites
What is the most common complication of venipuncture?
Thrombosis
Infection
Hematoma
Anemia
Hematoma formation due to blood leakage into surrounding tissue is the most frequent complication, often caused by needle misplacement or failing to apply sufficient pressure post-draw. Proper technique and post-procedure care minimize risk. CDC Complications
Why should blood collection tubes be gently inverted immediately after collection?
To warm the sample
To cool the sample
To aid in labeling
To mix blood evenly with tube additives
Gently inverting tubes the recommended number of times ensures proper mixing of blood with clot activators or anticoagulants, preventing clot formation or incomplete separation. Vigorous shaking causes hemolysis. CLSI Mixing Techniques
What effect does 'fist pumping' have on a patient during venipuncture?
Prevents hematoma formation
Leads to hemolysis and altered test results
Increases plasma proteins and potassium levels
Enhances flow without side effects
Repeated fist pumping can cause hemoconcentration and hemolysis, artificially elevating potassium, proteins, and other analytes, compromising specimen integrity. Encourage a relaxed fist. CDC Specimen Quality
Which personal protective equipment (PPE) is essential for performing phlebotomy safely?
Surgical gown only
No PPE is required
Gloves
Face shield only
Wearing gloves during blood collection protects both the healthcare worker and patient from cross-contamination and exposure to bloodborne pathogens. Additional PPE may be needed if splashes are anticipated. OSHA Bloodborne Pathogens
Which color tube is specifically used for coagulation studies such as PT/INR?
Green
Light blue
Red
Lavender
Light-blue-top tubes contain sodium citrate anticoagulant at a strict 9:1 blood-to-additive ratio, essential for accurate coagulation testing. Underfilling alters results. CLSI Coagulation
Which needle gauge is most appropriate for pediatric blood draws to minimize vein trauma?
18 gauge
21 gauge
23 gauge
25 gauge
A 23-gauge needle is often used for pediatric patients because its smaller diameter reduces vein trauma and discomfort while still allowing sufficient flow. NCBI Pediatric Phlebotomy
When is a butterfly (winged infusion) needle preferred over a straight needle?
In patients with small or fragile veins
For large-volume blood collections
For coagulation studies only
When speed is the top priority
Butterfly needles provide greater control and less trauma in patients with small, fragile, or rolling veins, such as the elderly or pediatrics. Their wings allow finer movement. CLSI Butterfly Technique
Which additive prevents glycolysis in glucose testing when collected in gray-top tubes?
Sodium fluoride
Sodium citrate
EDTA
Heparin
Gray-top tubes contain sodium fluoride, which inhibits glycolytic enzymes, preserving blood glucose levels up to 24 hours. This ensures accurate glucose measurements. CDC Sample Stability
Why is bevel orientation important during needle insertion?
It prevents tube vacuum loss
It anchors the vein
It speeds up blood clotting
It reduces pain and tissue trauma
Inserting the needle with the bevel up allows a smoother entry through skin and vessel wall, minimizing patient discomfort and reducing the risk of trauma. Phlebotomy Resources
How long should you allow the antiseptic to air dry on the skin before venipuncture?
30 seconds
60 seconds
10 seconds
5 seconds
Allowing the site to air dry for at least 30 seconds ensures complete antiseptic action and prevents hemolysis or contamination due to residual alcohol entering the sample. CDC Antisepsis
When might a dorsal hand vein be selected for venipuncture?
Only for arterial blood gas sampling
To reduce risk of hematoma in all cases
For routine large-volume collections
When antecubital veins are inaccessible or unsuitable
Dorsal hand veins can be used when antecubital veins are scarred, small, or have been frequently used. However, they carry higher risk of nerve damage and require careful technique. CLSI Venous Selection
After removing the needle, how long should direct pressure be applied to the site for a standard venipuncture?
30 seconds
2 - 3 minutes
10 seconds
5 - 7 minutes
Applying firm pressure for 2 - 3 minutes helps ensure hemostasis, preventing hematoma and excessive bleeding without compromising patient comfort. CDC Post-Procedure Care
Which practice most commonly causes hemolysis in a blood sample?
Allowing the alcohol to dry before puncture
Using a needle that is too large
Vigorously shaking the tube
Gently inverting the tube five times
Vigorous shaking disrupts red blood cell membranes, causing hemolysis. Gently invert tubes as specified by the manufacturer to mix additives properly. CLSI Mixing Guidance
Which of the following can cause cross-contamination between tubes during collection?
Not changing gloves between patients
Not inverting tubes after collection
Changing the tube without re-anchoring the vein
Collecting an EDTA tube before a coagulation tube
Collecting EDTA tubes before coagulation tubes may introduce EDTA into the coagulation sample, altering calcium-dependent test results. Follow proper order of draw. CLSI Order of Draw
Which action should you take if you notice a tube is past its expiration date before drawing?
Remove it from inventory and select a valid tube
Use it if looks undamaged
Draw partial volume only
Discard all tubes of that color on the rack
Expired tubes may have degraded additives or compromised vacuum, leading to invalid results. Always check tube expiration and remove unusable tubes from inventory. CLSI Inventory
Which tube additive prevents platelet aggregation and is used for ammonia testing?
Oxalate
Lithium heparin
Heparin
EDTA
Lithium heparin in green-top tubes prevents clotting without platelet aggregation and is preferred for ammonia and other plasma chemistries. NCBI Additives
When is the optimal time to label blood collection tubes?
Whenever convenient later in the shift
At the patient's bedside immediately after collection
At the draw station before going to patient
After returning to the laboratory
Labeling tubes at the bedside immediately after collection ensures correct specimen identification and prevents mix-ups. Labels should include at least two identifiers and collection time. CDC Labeling
Which practice reduces the risk of needlestick injuries after collection?
Recapping using a one-handed scoop or safety device
Leaving the needle uncapped until disposal
Bending the needle before disposal
Recapping with both hands
Using a one-handed scoop technique or activating the needle's built-in safety feature prevents accidental punctures. Two-handed recapping is a leading cause of needlestick injuries. OSHA Sharps Safety
Which additive chelates calcium ions to prevent coagulation in EDTA tubes?
Potassium oxalate
Ethylenediaminetetraacetic acid (EDTA)
Heparin
Sodium citrate
EDTA acts by binding calcium ions, which are essential cofactors in the coagulation cascade, thereby preventing clot formation. This preserves cellular elements for hematology assays. NCBI EDTA
What mechanism in evacuated tube systems draws blood into the tube?
Negative vacuum inside the tube
Manual suction by the phlebotomist
Gravity
Positive internal pressure
Evacuated tubes are pre-evacuated to create negative pressure, which draws the correct volume of blood into the tube when the needle punctures the stopper. This ensures consistent fill volumes. CLSI Evacuated Systems
Which tube contains a clot activator to expedite serum separation?
Light-blue-top
Green-top with heparin
Gold (SST) with silica particles
Red-top without gel
Gold-top SST tubes contain silica clot activators and a thixotropic gel that speeds clot formation and separates serum from cells upon centrifugation. NCBI SST
What is the recommended practice for enhancing venous dilation in geriatric patients?
Apply a warm compress for 3 - 5 minutes
Use only a blood pressure cuff instead of a tourniquet
Encourage vigorous fist pumping
Apply a cold pack for 5 minutes
A warm compress for 3 - 5 minutes increases local blood flow and vein dilation in elderly patients, facilitating easier venipuncture with minimal discomfort. NCBI Geriatric Phlebotomy
Which lab result is most likely to be falsely elevated by hemolysis?
Glucose
Potassium
Calcium
Sodium
Hemolysis releases intracellular potassium into the plasma, causing falsely elevated potassium results. Recognizing hemolyzed samples is essential for accurate interpretation. CDC Hemolysis
Tourniquet application longer than one minute can cause which preanalytical error?
Acidosis
Hemoconcentration
Lipemia
Glycolysis
Prolonged tourniquet time leads to hemoconcentration by causing water and small molecules to shift out of the vascular space, resulting in artificially elevated levels of proteins and cells. CLSI Hemoconcentration
Which needle gauge selection is least likely to cause hemolysis in delicate veins?
21 gauge
27 gauge
18 gauge
25 gauge
A 21-gauge needle provides an optimal balance between flow rate and minimal shear stress on red blood cells, reducing the risk of hemolysis compared to very small or very large needles. CLSI Needle Selection
How does lipemia appear in a centrifuged blood specimen?
Milky or cloudy plasma
Red-tinged plasma
Clear, yellow plasma layer
Greenish plasma
Lipemic specimens present as a milky or cloudy plasma layer due to high triglyceride content, which can interfere with many laboratory assays. NCBI Preanalytical
Which tube color is specifically intended for trace metal analysis?
Royal blue with EDTA
Lavender with EDTA
Green with heparin
Yellow with SPS
Royal blue-top tubes are manufactured with special low-contaminant plastics and either EDTA or no additive, making them ideal for accurate trace metal analysis. CLSI Trace Metals
Which OSHA regulation specifically addresses bloodborne pathogens in healthcare settings?
29 CFR 1910.1030
29 CFR 1910.1000
29 CFR 1926.50
29 CFR 1910.1200
OSHA's Bloodborne Pathogens Standard is codified in 29 CFR 1910.1030, which mandates safe work practices, engineering controls, and training to protect healthcare workers from exposure. OSHA BBP
What is the ideal needle insertion angle for accessing a dorsal hand vein?
30 - 45 degrees
90 degrees
5 - 10 degrees
60 - 75 degrees
A shallow insertion angle of 5 - 10° is recommended for dorsal hand veins to prevent piercing through both walls, as these veins are more superficial and less anchored than antecubital veins. CLSI Technique
Which antiseptic agent is preferred for blood culture collection?
Povidone-iodine only
70% isopropyl alcohol only
Plain soapy water
Chlorhexidine gluconate with alcohol
Chlorhexidine gluconate with alcohol provides rapid and sustained antimicrobial action, reducing skin flora contamination in blood cultures. It is preferred by most guidelines. CLSI Blood Cultures
Light-blue-top coagulation tubes must be filled to approximately what percentage to maintain the correct blood-to-additive ratio?
50%
90%
100%
75%
Light-blue-top (sodium citrate) tubes require a 9:1 blood-to-additive ratio, necessitating a fill volume of at least 90% to ensure accurate coagulation testing. Underfilled tubes yield erroneous results. CLSI Fill Volumes
What is the primary function of thixotropic gel in serum separator tubes (SST)?
Act as an anticoagulant
Prevent glycolysis
Enhance clotting time
Form a physical barrier between serum and cells after centrifugation
Thixotropic gel migrates during centrifugation to form a stable barrier between the serum and cellular components, preventing cross-contamination and preserving sample integrity. NCBI Separator Gel
Royal blue-top tubes for trace element analysis come in two additive options. Which additive is used for lead testing?
Potassium oxalate
EDTA
No additive (plain)
Sodium fluoride
Royal blue-top tubes with EDTA are recommended for lead and other heavy metal testing because EDTA chelates metal ions and stabilizes them, ensuring accurate measurement. CLSI Trace Metals
Which enzyme is inhibited by sodium fluoride in gray-top tubes to prevent glycolysis?
Phosphofructokinase
Pyruvate kinase
Enolase
Hexokinase
Sodium fluoride inhibits enolase, an enzyme late in the glycolytic pathway, thus preserving glucose levels in whole blood samples until analysis. NCBI Glycolysis Inhibition
What advanced patient factor can significantly alter coagulation test results if not standardized before collection?
Blood alcohol level
Time of day
Patient posture (supine vs. sitting)
Room temperature
Changes in patient posture can shift plasma volume and protein concentrations, significantly affecting coagulation parameters. Standardizing posture (usually sitting) is crucial for reproducible results. CLSI Preanalytical
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Study Outcomes

  1. Identify Needle Gauge Sizes -

    Understand the numerical ranges of needle gauges, including which gauges are most commonly used for blood donation needles are which of the following gauges in phlebotomy practice.

  2. Apply Venipuncture Techniques -

    Demonstrate proper step-by-step blood draw procedures and order of draw, ensuring accurate sample collection every time.

  3. Implement Safety Protocols -

    Recognize and apply infection control measures, sharps disposal guidelines, and patient safety best practices during every draw.

  4. Troubleshoot Common Complications -

    Analyze real-world scenarios such as hematomas or collapsed veins and select appropriate corrective actions.

  5. Prepare for Certification Exams -

    Use targeted phlebotomy quiz questions and phlebotomy exam practice materials to boost confidence and readiness for certification tests.

Cheat Sheet

  1. Needle Gauge Fundamentals -

    Understanding needle gauges is key: higher gauge equals smaller diameter. Blood donation needles are commonly 16 - 18 gauge (16G = 1.65 mm, 18G = 1.27 mm) for optimal flow and donor comfort. Mnemonic "Large Grain, Wider Flow" helps recall that a lower gauge yields a larger lumen and is often tested on a phlebotomy quiz.

  2. Order of Draw Protocol -

    Following the correct tube sequence prevents cross-contamination of additives. The CLSI-recommended order - blood culture, light blue, serum, heparin, EDTA, oxalate - can be memorized with "Becoming Light Saves Healthy Erythrocytes Optimally." Proper order ensures reliable lab results.

  3. Venipuncture Site Selection -

    The median cubital vein is preferred for its stability and accessibility, followed by the cephalic and basilic veins. Proper arm positioning and a visible, palpable vein reduce complications. Always assess vein resilience and skin integrity before inserting the needle.

  4. Evacuated Tube System Mechanics -

    Vacuum tubes rely on negative pressure to draw the correct blood volume; overfilling skews additive ratios, while underfilling yields incomplete tests. Recognize tube additives - EDTA for hematology, citrate for coagulation - and invert tubes gently 5 - 10 times. Accurate fill ensures valid results for phlebotomy exam practice questions.

  5. Safety & Infection Control -

    Apply the CDC's guidelines: perform hand hygiene, don gloves, and clean the site with 70% isopropyl alcohol for 30 seconds. Never recap needles and discard them immediately in a puncture-resistant sharps container. A quick safety timeout and clear labeling uphold best practices for certification test success.

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