Written to NHA's CPT test plan
- Safety and Compliance 26%
- Patient Preparation 20%
- Routine Blood Collections 28%
- Special Collections 12%
- Processing 14%
Free · 2026 · 26% of the NHA CPT Phlebotomy Safety and Compliance practice questions
Safety and Compliance is 26% of the NHA CPT. Answer 10 questions (6 on Safety and Compliance) and see your score by domain, with every answer explained. Free, no sign-up.
Hospital policy states that only trained registered nurses may access central venous devices. A busy nurse asks the phlebotomist to draw blood from a patient's PICC line because the patient's arm veins are poor. The phlebotomist has not been trained or authorized to access these lines. What is the best response?
Tap an answer, or press A to D
OSHA, HIPAA and CLSI rules, sharps and exposure control, PPE and isolation precautions, quality control, first aid and incident reports.
What the NHA CPT exam tests in Safety and Compliance
- Workplace safety and operational standards: OSHA (Bloodborne Pathogens Standard, Hazard Communication and Safety Data Sheets), NIOSH, CDC, The Joint Commission, CLSI, College of American Pathologists, CLIA; fire, electrical and chemical safety
- HIPAA and protected health information, the patient's rights, scope of practice for phlebotomy technicians, ethical standards (NHA code of ethics), and legal concepts (consent vs battery, negligence, malpractice)
- Quality control for laboratory equipment: inspection and maintenance logs, manufacturer calibration and maintenance, reporting and troubleshooting equipment problems, refrigerator and freezer temperature monitoring
- Quality control for point-of-care and CLIA-waived tests: running controls, calibration, storage of reagents and strips, lot changes, what to do when controls fail
- Sharps and biohazard disposal under the Bloodborne Pathogens Standard and the Needlestick Safety and Prevention Act: safety-engineered devices, never recapping, single-use tube holders, sharps containers, glass slides and urine transfer devices, biohazard bags, blood spill cleanup and disinfection
- Exposure control plans: needlestick, cut and splash response, eyewash and handwashing, immediate reporting, post-exposure evaluation, hepatitis B vaccination
- Infection control: chain of infection, hand hygiene, standard precautions, PPE selection and donning/doffing order, transmission-based precautions (contact, droplet, airborne, COVID-19), protective isolation, aseptic technique, antiseptics vs disinfectants
- Emergencies and first aid during phlebotomy: CPR and responding to codes, excessive bleeding, falls, fainting (syncope), hypoglycemia and hyperglycemia, seizures
- Documentation and reporting: incident and occurrence reports, charting guidelines and error correction, reporting requirements
High-yield safety and compliance facts
- OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) employer duties: written exposure control plan reviewed and updated at least yearly; engineering controls (sharps containers, safety needles and lancets) and work-practice controls; PPE at no cost; training at hire and yearly; biohazard labels (fluorescent orange or orange-red symbol) or red bags and containers.
- Hepatitis B vaccine is offered free within 10 working days of assignment. An employee may decline in writing and can still get it later. Post-exposure evaluation is also free.
- HBV is the bloodborne pathogen most transmissible by needlestick. A vaccine exists for HBV only, not for HCV or HIV.
- Needlestick Safety and Prevention Act (2000): employers must evaluate and use safety-engineered devices, review them yearly, get front-line worker input on device choice, and keep a sharps injury log.
- Universal precautions (older OSHA term) treat blood and certain fluids as infectious. Standard precautions (CDC) cover blood, all body fluids except sweat, non-intact skin and mucous membranes of every patient.
- Work-practice bans in specimen areas: eating, drinking, smoking, cosmetics or lip balm, handling contact lenses, food in specimen refrigerators, mouth pipetting.
| Body | Role for phlebotomy |
|---|---|
| OSHA (Dept. of Labor) | ENFORCES workplace safety: Bloodborne Pathogens Std, Hazard Communication Std |
| NIOSH (part of CDC) | Researches and recommends worker safety; certifies N95 respirators; does not enforce |
| CDC | Infection-control guidance: hand hygiene, standard and transmission-based precautions, post-exposure care |
| CLSI | Voluntary consensus lab standards: venipuncture, capillary puncture, order of draw, processing |
| The Joint Commission | Accredits hospitals; National Patient Safety Goals (2 identifiers, label in the patient's presence, report critical results promptly, hand hygiene) |
| CAP | Accredits and inspects laboratories |
| CMS | Runs the CLIA program (and Medicare) |
| CLIA '88 | Any lab testing human specimens needs a certificate; tests are waived, moderate or high complexity |
The full Phlebotomy High-Yield Cram Sheet comes with full prep.
Common safety and compliance traps
- OSHA enforces; NIOSH and CDC recommend; CLSI writes standards; TJC and CAP accredit.
- HBV vaccine: free, offered within 10 working days; declining must be in writing.
- Activate the safety device immediately; the needle and holder go in the sharps container together.
- Report an exposure immediately, not at the end of the shift; never squeeze the wound or use bleach on skin.
- Alcohol rub doesn't kill C. difficile spores; wash with soap and water.
- Gloves go on last and come off first; a respirator comes off outside the room.
- N95 for TB, measles and chickenpox; a surgical mask for flu and pertussis.
- Antiseptic on skin, disinfectant on surfaces.
Free Phlebotomy safety and compliance practice questions
Question 1
While a phlebotomist is removing a stopper during aliquoting, serum splashes into one eye. The phlebotomist was not wearing a face shield. What is the correct response?
- AFlush the eye at the eyewash station for about 15 minutes, then report it right away
- BCover the eye with sterile gauze and wait for the supervisor before rinsing it
- CRinse the eye briefly at the sink, finish the batch, and report it at the end of the shift
- DWipe the eye with a 70% isopropyl alcohol pad, then report it to the supervisor
Show answer and explanation
Answer: A. mucous membrane splashes to the eye are irrigated promptly with an eyewash station, clean water or saline (commonly for 15 minutes), followed by immediate reporting and medical evaluation.
Why not B: irrigation must start immediately. Waiting gives the material more contact time with the mucous membrane.
Why not C: a brief rinse isn't adequate irrigation, and exposures must be reported immediately so the evaluation and any treatment aren't delayed.
Why not D: alcohol would injure the eye and doesn't flush the material out. Only water or saline is used to irrigate eyes.
Remember: For an eye splash, flush right away at the eyewash station (about 15 minutes), then report immediately.
Question 2
A phlebotomist loads a centrifuge with properly balanced, stoppered tubes and latches the lid. Once it reaches speed, the centrifuge shakes violently and makes a grinding noise. What is the most appropriate action?
- AOpen the lid as it slows down to check and rebalance the tubes
- BTurn it off, wait for the rotor to stop, then tag it out of service, report it and document the problem
- CLet the run finish, since the tubes were already balanced correctly
- DRemove the housing after it stops and tighten the motor mount
Show answer and explanation
Answer: B. Faulty equipment is stopped safely, removed from use and reported, and the problem is logged so service can follow the manufacturer's instructions.
Why not A: The lid must never be opened until the rotor has stopped completely, because of injury and aerosol risks.
Why not C: Continuing to run a malfunctioning centrifuge risks broken tubes, aerosols, equipment damage and injury.
Why not D: Internal repairs belong to qualified service personnel following the manufacturer's instructions, not to the phlebotomist.
Remember: Stop malfunctioning equipment safely, label it out of service, report it and document it; leave repairs to authorized service.
Question 3
During morning quality control on a CLIA-waived glucose meter, the normal-level control is in range but the high-level control is out of range. Three patients are waiting for fingerstick glucose tests. What is the best action?
- ATest the patients, because the normal control passed and most patients' results fall near normal
- BHold patient testing, troubleshoot strips, control solution and meter, repeat controls, and escalate if they still fail
- CTest the patients and add a comment to each result stating that quality control is pending
- DRecord the high control as acceptable because the reading was only slightly outside the range
Show answer and explanation
Answer: B. Failed QC means no patient testing until the cause is found and corrected and controls pass; persistent failures go to the supervisor.
Why not A: Every required control level must pass; a failed high control means results in any range may be inaccurate.
Why not C: Results must not be produced or reported while QC is failing; a comment does not make an unverified result reliable.
Why not D: Recording a failed value as acceptable is falsification; any value outside the stated range is a failure.
Remember: If any required control level fails, stop patient testing, troubleshoot, repeat and escalate before resuming.
Question 4
An outpatient became lightheaded after a draw and slid from the drawing chair to the floor. Which entry is written most appropriately for the incident report?
- APatient fainted, most likely because she ignored instructions and skipped breakfast, as nervous patients usually do.
- BAt 0915 patient stated "I feel dizzy" and slid from chair to floor; no visible injury; RN notified at 0917.
- CI may have caused this fall by working too slowly, and I accept full blame for the patient's injury.
- DPatient seemed fine after the fall, so it was probably nothing serious and needs no follow-up.
Show answer and explanation
Answer: B. This entry is objective, includes times, quotes the patient, describes what was observed and records who was notified.
Why not A: This entry guesses at the cause and passes judgment on the patient instead of recording observed facts.
Why not C: An incident report records facts, not personal opinions, admissions of fault or claims of injury that weren't observed.
Why not D: This entry is vague and draws a medical conclusion the phlebotomist isn't qualified to make.
Remember: Incident reports should be prompt, factual and objective, giving times, observations, the patient's own words and who was notified, with no blame or speculation.
Question 5
At the start of the shift, a phlebotomist checks the specimen refrigerator. The posted acceptable range is 2-8 °C, and the thermometer reads 12 °C. The refrigerator holds patient specimens and test reagents. What is the most appropriate action?
- ATurn the thermostat colder and record 5 °C, since the unit will soon return to range
- BRecord 12 °C, move the contents to a unit within range per policy, notify the supervisor and document the corrective action
- CDiscard everything in the refrigerator immediately without telling anyone
- DRecord 12 °C and recheck tomorrow morning before taking any further action
Show answer and explanation
Answer: B. Record the actual reading, protect the specimens and reagents, escalate the problem and document what was done.
Why not A: Recording a value that was not observed falsifies the log. Adjusting the thermostat does not protect the items already exposed to the warm temperature.
Why not C: Whether items must be discarded is decided under the facility policy and by the supervisor. Discarding them silently also skips the required reporting and documentation.
Why not D: Waiting a day leaves specimens and reagents at an unacceptable temperature. An out-of-range reading requires prompt corrective action and notification.
Remember: For an out-of-range temperature, record the true reading, protect the contents per policy, notify the supervisor and document the corrective action.
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- 300+ Phlebotomy practice questions, every answer choice explained
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- Order of Draw Sequencer: all 15 rounds
- Full 15-page printable High-Yield Cram Sheet (PDF)
100% Pass Guarantee + 7-day money-back. How it works