NHA CPT Phlebotomy Exam Content Outline 2026

It asks you to: The largest domain: you sequence the draw, pick the correct tube and order of draw for a set of ordered tests, troubleshoot a draw that stops flowing (redirect, change angle, change tube), and respond when a patient shows signs of syncope or nerve involvement.

• Select and assemble equipment (evacuated tube system, syringe, winged set) and needle gauge
• Equipment quality checks (sterility, expiration, defects)
• Tourniquet application/removal, palpation, antisepsis, anchoring the vein, angle of insertion
• Order of draw for venipuncture and for capillary collection
• Tube additives, fill level/ratios and number of inversions
• Recognize and respond to complications (hematoma, no blood flow, nerve pain, syncope)
• Dermal (capillary) puncture procedure
• Post-procedure care and specimen labeling

It asks you to: Scenario questions where you pick the correct next step after something goes wrong (a needlestick, a blood spill, a fainting patient, an out-of-range fridge log) or choose the right PPE and precaution level for a given patient.

• Workplace safety regulations (OSHA, NIOSH) and operational standards (The Joint Commission, CLSI, CDC)
• HIPAA and Protected Health Information
• Scope of practice and ethical standards (NHA code of ethics)
• Quality control for lab equipment, POC and CLIA-waived tests (logs, calibration, refrigerator/freezer temps)
• Sharps/biohazard disposal and the Bloodborne Pathogens Standard
• Exposure control plans (needlesticks, blood spills, eye contamination)
• Transmission-based and standard precautions, PPE, hand hygiene
• Emergency response, CPR and first aid; incident documentation and reporting

It asks you to: Questions test what you must confirm before the needle comes out: whether the ID is sufficient, whether a non-fasting patient can proceed, who can consent for a minor or a patient with dementia, and which arm or site you may not use (e.g. a fistula side).

• Obtain, review and verify orders/requisitions (STAT, routine, timed draws)
• Positive patient identification using required identifiers
• Implied, informed and expressed consent; guardian permission
• Insurance, copays, registration and billing documentation (incl. ICD-10-CM coding)
• Verify patient compliance with fasting, medication, basal-state requirements
• Interview for allergies, fainting history and other special considerations
• Patient positioning and venipuncture site selection per CLSI
• Instruct patients on non-blood specimen collection (urine, stool, semen, sputum)

It asks you to: Questions ask how to keep a specimen valid after collection: which samples go on ice or are protected from light, when to spin and separate, what breaks chain of custody, and what to do when a POC result comes back critical.

• Centrifuging and aliquoting specimens
• Handling requirements for temperature, light and time
• Chain of custody (forensic, blood alcohol)
• Clinical research lab protocols and shipping (specimen bags, air waybills)
• Entering and retrieving data in the laboratory information system
• Recognize and report critical values for POC/CLIA-waived tests
• Result distribution and patient re-collection

It asks you to: Expect procedure-specific details: which bottle fills first in a blood culture, why alcohol is avoided for blood alcohol site prep, how timing works for a glucose tolerance test, and how much blood can safely be drawn from a small child.

• Blood culture collection (skin prep, bottle order, volumes)
• Newborn/metabolic screening on filter paper (PKU, galactosemia)
• Pediatric/geriatric volume limits and assisting with line draws
• Blood donation phlebotomy and donor screening
• Point-of-care testing (H&H, glucose, urine pregnancy, urinalysis)
• Tolerance tests (gestational glucose, lactose, 2-hour post-prandial)
• Blood alcohol site prep and drug-screen collection