Routine Blood Collections is 28 of the 100 scored items on the NHA CPT exam. Answer 10 exam style questions on vein selection, tourniquet and site prep and see exactly which concepts would cost you points on test day.
Start the 10 questions →Which antecubital vein is usually the first choice because it is well anchored and less painful to puncture?
These questions cover vein selection, tourniquet, site preparation, venipuncture technique and equipment. 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.
Prefer to read first? Every question from the practice set above, with the correct answer and why each wrong option is wrong.
Answer: D. The median cubital vein is usually large, well anchored and away from major nerves and arteries, making it the first choice.
Why not A: The cephalic vein is a good second choice but often harder to feel.
Why not B: The basilic vein is last because it lies near the brachial artery and a nerve.
Why not C: An artery is never used for routine venipuncture.
Exam tactic: Median cubital first.
Answer: D. Placing the tourniquet over a sleeve or thin layer of material protects fragile skin from pinching while still letting the veins fill.
Why not A: Upper arm placement is acceptable, the issue is protecting the skin.
Why not B: Extra tightness increases skin injury and petechiae.
Why not C: Five minutes is far beyond the recommended tourniquet time.
Exam tactic: Fragile skin: add a layer.
Answer: C. 70% isopropyl alcohol is the standard antiseptic for routine venipuncture. It is applied and allowed to air dry. Blood cultures and blood alcohol tests call for different antiseptics.
Why not A: Soap and water cleans but is not the standard skin antiseptic for venipuncture.
Why not B: Hydrogen peroxide is not a venipuncture antiseptic.
Why not D: Povidone-iodine is reserved for special collections such as some blood cultures; routine draws use 70% isopropyl alcohol.
Exam tactic: Routine draw: 70% isopropyl, air dry.
Answer: C. A slight change in needle depth may locate the vein. Blind probing, especially sideways, risks nerve and artery injury. If adjustment fails, the needle is removed and a new site is used.
Why not A: Going deeper risks passing through the vein into an artery or nerve.
Why not B: Lateral probing can injure nerves and is painful.
Why not D: Reapplying or tightening a tourniquet with the needle in place does not fix a missed vein.
Exam tactic: Small depth change only. Never probe sideways.
Answer: B. The rubber sleeve covers the tube side of the needle and prevents blood from leaking into the holder when tubes are switched.
Why not A: It has no connection to the tourniquet.
Why not C: Volume is controlled by the tube vacuum.
Why not D: It does not sterilize anything; it is a valve that covers the back needle to stop leakage.
Exam tactic: Sleeve = no leak between tubes.
Answer: C. A shallow angle of 30 degrees or less (often 15 to 30 degrees) lets the needle enter the vein without passing through it.
Why not A: 45 degrees is steep enough to risk going through the back of the vein.
Why not B: 60 degrees is far too steep and risks passing through the vein.
Why not D: A perpendicular entry is used for injections into muscle, not for venipuncture.
Exam tactic: Shallow: 30 degrees or less.
Answer: B. A tight rolled sleeve can act like a tourniquet and affect blood flow and results. The patient removes the arm from the sleeve or loosens it.
Why not A: A sleeve acting as a tourniquet cannot be timed or released.
Why not C: Cutting clothing is not appropriate.
Why not D: A longer tourniquet time adds hemoconcentration.
Exam tactic: Tight sleeve, second tourniquet.
Answer: C. Letting the arm hang down briefly helps veins fill with blood. Warming can also help.
Why not A: Holding the breath does not fill arm veins.
Why not B: Raising the arm drains blood from the veins.
Why not D: Tapping hard with equipment is unsafe and does not reliably help.
Exam tactic: Let gravity fill the vein.
Answer: B. Arteries have a pulse and thicker, more elastic walls. A suitable vein feels soft and bouncy and has no pulse.
Why not A: A soft, bouncy, compressible feel describes a good vein, not an artery; an artery pulsates.
Why not C: Veins do not pulsate.
Why not D: A hard, cord like vein is sclerosed and should be avoided.
Exam tactic: Pulse = artery. Bouncy, no pulse = vein.
Answer: C. The tourniquet should impede venous flow while arterial flow continues; the radial pulse should still be felt. Excess pressure is painful and can cause petechiae and hemoconcentration.
Why not A: Blue fingers mean circulation is compromised; the tourniquet is far too tight.
Why not B: Excessive tightness blocks arterial flow and harms the specimen.
Why not D: A loose tourniquet does not fill the veins.
Exam tactic: Pulse still there = tourniquet right.
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