NHA CPT Practice Questions 2026: 8 Exam-Style Items Explained

Answer: B — Hold the draw and have the nursing staff correct the ID band before collecting

Positive identification requires the patient's stated identifiers, the ID band and the requisition to match exactly before collection. When they do not, the discrepancy is resolved first, and in a hospital that means the nursing staff correct the band. A STAT label and a verbal reassurance do not change the rule, because wrong-blood-in-tube errors can cause fatal transfusion reactions.

• A. Verbal confirmation does not override an ID band that disagrees; every identifier must match before the needle comes out.
• C. Hand-correcting the label produces an unverified specimen and hides the error instead of fixing it at the source.
• D. Collecting first and fixing the band later is the exact sequence that produces mislabeled specimens; the band is corrected before the draw.

Answer: A — EDTA carried over into the serum tube

K2EDTA binds calcium and is a potassium salt, so even a small carryover into a serum tube falsely lowers calcium and falsely raises potassium. That is why the CLSI order of draw places serum and gel tubes before EDTA. A very low calcium with a high potassium in a patient who looks well is the textbook signature of this error.

• B. Underfilling an SST mainly reduces serum volume; it does not create the specific low-calcium, high-potassium pattern.
• C. A 21-gauge needle is the standard size for adult venipuncture and does not cause hemolysis; hemolysis also would not lower calcium.
• D. Releasing the tourniquet once blood flow is established is correct technique and does not distort chemistry results.

Answer: B — Collecting them first keeps the sterile specimen free of skin flora and additives from other tubes

Blood cultures head the CLSI order of draw because they must stay sterile. Drawing them before any other tube means nothing from another stopper or additive has touched the needle, and the special skin prep is done immediately before. A contaminated culture can grow skin bacteria, leading to unnecessary antibiotics and longer hospital stays.

• A. Volume does not set the order of draw; the order exists to prevent contamination and additive carryover.
• C. Organisms in a culture specimen do not die within seconds; the concern is contamination, not survival.
• D. Culture media do contain an anticoagulant (SPS), but that is not why they are drawn first; sterility is.

Answer: A — The patient wears a surgical mask; the phlebotomist does not need one during transport

CDC's isolation guideline says a patient on droplet precautions who must be moved wears a mask and follows cough etiquette, and no mask is required for the person transporting them. Masking the patient contains droplets at the source. The phlebotomist puts on a mask once in close contact for the draw itself.

• B. N95 respirators belong to airborne precautions (for example TB, measles, varicella); influenza calls for droplet precautions.
• C. Masking only the worker leaves the source uncontrolled; during transport the patient is the one who must be masked.
• D. A short trip does not remove the need for source control; the patient wears a mask whenever outside the room.

Answer: D — Droplet

Influenza spreads mainly by large respiratory droplets, so CDC places patients with suspected or confirmed flu on droplet precautions on top of standard precautions. Anyone in close contact wears a surgical mask, and the patient is masked when moved. Swabbing puts you face to face with the patient, so mask before you start.

• A. Standard precautions always apply, but influenza needs the added droplet layer, including a mask.
• B. Airborne precautions (N95, negative-pressure room) are for organisms such as TB, measles and varicella, not routine influenza.
• C. Contact precautions target organisms spread by touch, such as MRSA or C. difficile; they do not address respiratory droplets.

Answer: C — Using a 20-gauge needle on a good antecubital vein

Hemolysis comes from mechanical damage to red cells: strong suction, drawing through damaged tissue, very small needles under high pressure, and rough mixing. A 20-gauge needle is within the normal range for adult venipuncture and does not cause hemolysis with correct technique. Small-bore needles, such as 25 gauge, are the ones linked to hemolysis.

• A. Forceful plunger suction drags cells through the needle under high shear and ruptures them.
• B. Blood from a hematoma site contains damaged cells and tissue fluid, so the specimen can be hemolyzed and inaccurate.
• D. Shaking ruptures red cells; additive tubes are inverted gently the recommended number of times.

Answer: B — Twist the stopper off slowly behind a bench-top splash shield, with the tube pointed away from the face

Removing a stopper can release an aerosol or spray of serum or plasma, a bloodborne pathogen exposure route to the eyes, nose and mouth. The safe technique is to work behind a splash shield (or wear face protection), often with gauze over the stopper, and twist it off gently with the tube pointed away. Processing is where face protection matters, even though the tube is capped and spun.

• A. Thumb-popping is the classic way to spray specimen and is specifically discouraged.
• C. Levering against a counter is uncontrolled, can crack the tube and splashes the contents.
• D. Pushing the stopper in contaminates the specimen and can still spray it; the stopper is removed, not forced inward.

Answer: A — Inspect the needle, ask the patient to close the hand, anchor the vein, insert the needle

The needle is inspected for defects before it goes near the skin. The patient closes the hand (without pumping) to make the vein more prominent, the vein is anchored by pulling the skin taut below the site, and the needle is inserted bevel up at an angle of 30 degrees or less. Anchoring before insertion keeps the vein from rolling.

• B. Inspecting the needle after insertion is too late, and the hand should be closed before the needle goes in, not after.
• C. The vein must be anchored before insertion; anchoring afterward lets it roll away from the needle.
• D. Fist pumping is discouraged because it can falsely raise potassium, and the needle must be inspected before insertion, not at the end.