PassPulsePhlebotomySee how it works
Free Phlebotomy practice · Updated October 2026

Phlebotomy specimen handling, stability and rejection practice questions, with every answer explained

Processing is 14 of the 100 scored items on the NHA CPT exam. Answer 10 exam style questions on specimen handling, stability and rejection and see exactly which concepts would cost you points on test day.

✓ 10 questions✓ Every answer explained✓ No sign up
Start the 10 questions →
Where the NHA CPT points are100 scored items
Routine Blood Collections
28
Safety and Compliance
26
Patient Preparation
20
Processing
14
Special Collections
12
Source: NHA CPT test plan (2025)You are here ↑
Score 0/0
Q1Stability

How soon should a blood smear be made from an EDTA tube for best cell appearance?

What these specimen handling, stability and rejection questions test

These questions cover stability, labeling, specimen quality, shipping and add-on tests. Each one shows the correct answer and why every other option is wrong, so a miss tells you exactly what to review before the NHA CPT.

StabilityLabelingSpecimen qualityShippingAdd-on testsTransportDocumentationRejectionSpecimen rejectionCritical values

All 10 questions with answers explained

Prefer to read first? Every question from the practice set above, with the correct answer and why each wrong option is wrong.

Q1How soon should a blood smear be made from an EDTA tube for best cell appearance?
  1. Only after centrifuging
  2. Only after freezing
  3. Within about 1 hour
  4. After 3 days

Answer: C. Smears are best made within about an hour of collection, because EDTA gradually changes cell morphology over time.

Why not A: Smears use well-mixed whole blood, not spun blood.

Why not B: Freezing destroys cells.

Why not D: Morphology deteriorates over days.

Exam tactic: Smear from EDTA: within about an hour.

Q2A specimen for a timed test arrives without a collection time on the label. Why is this a problem?
  1. The tube cannot be centrifuged
  2. The barcode will not scan
  3. It cannot be interpreted reliably and may need recollection
  4. It changes the reference range the analyzer uses for the patient's age group

Answer: C. For timed tests, the result means little without the exact collection time. Many labs reject it or require correction per strict policy.

Why not A: Centrifuging is not affected.

Why not B: Barcode scanning is separate from the time entry.

Why not D: The reference range itself does not change.

Exam tactic: No time, no timed test.

Q3Which collection error most often causes a clotted lavender tube?
  1. Using a 21 gauge needle
  2. Labeling it at the bedside
  3. Drawing it last in the order, after all other tubes
  4. Not inverting it right after the draw

Answer: D. EDTA must be mixed immediately with gentle inversions. Delayed or inadequate mixing lets microclots form.

Why not A: 21 gauge is standard.

Why not B: Bedside labeling is correct practice.

Why not C: Order of draw does not cause clotting in EDTA.

Exam tactic: Invert right away or it clots.

Q4Diagnostic specimens shipped by courier as Category B are labeled with which marking?
  1. Radioactive material
  2. UN3373 Biological Substance, Category B
  3. Flammable liquid
  4. Category C Biological Waste for regular mail

Answer: B. Diagnostic specimens shipped as Category B infectious substances carry the UN3373 marking with 'Biological Substance, Category B'.

Why not A: Radioactive labels are for radioactive materials.

Why not C: Flammable labels are for flammable liquids.

Why not D: There is no Category C for regular mail.

Exam tactic: Diagnostic shipping: UN3373.

Q5A provider requests an additional test on a specimen already in the lab. What must be checked first?
  1. That the tube is the right color, and nothing else
  2. Nothing, add-ons are always allowed
  3. That the specimen type and stability allow it
  4. That the patient paid

Answer: C. Add-on tests depend on the right tube, enough volume, and whether the analyte is still stable given the time and storage conditions.

Why not A: Stability and volume matter as much as tube type.

Why not B: Many add-ons are rejected for stability reasons.

Why not D: Payment is not a specimen quality check.

Exam tactic: Add-on: right tube, enough, still stable.

Q6Why do some labs avoid sending certain specimens through a pneumatic tube system?
  1. Agitation can hemolyze or disturb them
  2. It changes the patient's blood type
  3. It warms the specimens above room temperature in transit
  4. It removes the label

Answer: A. Rapid movement and pressure changes in pneumatic tubes can cause hemolysis or affect sensitive tests, so labs specify which specimens must be hand delivered.

Why not B: Blood type cannot change.

Why not C: Temperature change is not the main concern; agitation is.

Why not D: Labels are not removed.

Exam tactic: Some specimens: hand carry.

Q7What is recorded when a specimen is handed to a courier for another lab?
  1. Nothing, it is routine
  2. A specimen log with time and signatures
  3. Only the name of the receiving lab
  4. Only the patient's phone number

Answer: B. A transport log or manifest records which specimens left, when, and who handled them, so specimens can be traced.

Why not A: Documentation is required for traceability.

Why not C: The destination alone does not show which specimens left, when, or who took them.

Why not D: A phone number does not track specimens.

Exam tactic: Specimens leaving: log it.

Q8A specimen is rejected. What must happen next?
  1. Discard it without telling anyone
  2. Test it anyway and add a comment
  3. Document the reason and notify the care team
  4. Wait for the provider to call the lab and ask what happened to the result

Answer: C. Rejected specimens are documented with the reason, and the patient's care team is notified promptly so a new specimen can be collected.

Why not A: Silent discarding delays patient care.

Why not B: Testing a rejected specimen risks wrong results.

Why not D: Waiting delays care.

Exam tactic: Reject, record, notify.

Q9The lab receives a lavender tube for a CBC that contains small clots. What happens?
  1. The clots are removed and it is tested
  2. It is tested normally
  3. It is converted to a serum test
  4. It is rejected and recollected

Answer: D. Clots in an anticoagulated tube trap cells and platelets, so hematology results are invalid. The specimen is rejected and recollected.

Why not A: Removing clots does not restore accurate counts.

Why not B: Clotted samples give false counts.

Why not C: The order and tube must match.

Exam tactic: Clotted lavender = recollect.

Q10The lab finds a critical potassium result. What should happen?
  1. Wait and include it in the next routine report
  2. Call the provider now, with read back
  3. Email the result to the patient
  4. Quietly retest it the next day

Answer: B. Critical values are communicated immediately to the responsible provider or nurse, who reads the result back, and the call is documented with time and name.

Why not A: Critical values cannot wait for a routine report.

Why not C: Critical results go to the care team, not by email to patients.

Why not D: Delays can harm the patient.

Exam tactic: Critical value: call now, read back, document.

Check every NHA CPT area, not just this one

The free 20 question diagnostic covers all 5 areas of the NHA CPT outline and shows the 3 fixes worth the most points.

Take the free diagnostic

Practice another Phlebotomy topic

See all 22 Phlebotomy practice topics →

More about the NHA CPT

PassPulse is an independent exam preparation tool. We are not affiliated with, endorsed by, or sponsored by the National Healthcareer Association (NHA), the American Society for Clinical Pathology (ASCP), the National Center for Competency Testing (NCCT) or American Medical Technologists (AMT). Exam, credential and product names mentioned on this page are trademarks of their respective owners and are used only to identify the exams described.

These practice questions are written by PassPulse to reflect the published exam content outline. They are not actual exam questions. Questions, answers and explanations may contain errors or be out of date, and they are for exam study only, not for clinical or professional practice: always check facts against the certifying body's official materials, current standards and your employer's policies. Scores and projections on this page are estimates based on a small number of questions and do not predict your result on the real exam. Area weights come from the official outline as of the date shown; always confirm current exam details with the certifying body.
Preparing for the NHA CPT?Test yourself free
Take the test