Free ASCP Phlebotomy Technician (PBT) examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the ASCP Phlebotomy Technician (PBT) examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1While reviewing the route of a venous specimen through the circulation, a trainee asks where systemic venous blood first enters the heart. Which chamber receives it?

   1. A. Right atrium
   2. B. Left atrium
   3. C. Right ventricle
   4. D. Left ventricle

   Answer: A

   Explanation: "The right atrium receives deoxygenated blood from systemic veins; the left atrium receives oxygenated blood from the pulmonary veins." Systemic veins return blood to the right atrium; the other chambers occupy different positions in the pulmonary or systemic pathways.

   Reference: Structure of the Heart — Chambers of the Heart

2. 2An outpatient order lists a waived test, but its handwritten test name could refer to two different assays. Whom should the collector contact to establish the intended order before collection?

   1. A. The patient who brought the handwritten request
   2. B. The ordering clinician who wrote the request
   3. C. The technologist who will perform the assay
   4. D. The nurse who scheduled the collection

   Answer: B

   Explanation: "If there is a question, check with the ordering clinician." The prescriber of the ambiguous request can establish intended testing; the other participants cannot substitute their guess for the order.

   Reference: Good Laboratory Practices for Waived Testing Sites — Recommended Practices Before Testing, Test Orders

3. 3A serum sample for serologic testing is compared with the CDC hemolysis palette. What is the lowest displayed hemoglobin level at which CDC says the sample should not be processed?

   1. A. 50 mg/dL
   2. B. 75 mg/dL
   3. C. 100 mg/dL
   4. D. 150 mg/dL

   Answer: C

   Explanation: "Serum samples that match colors with 100 mg/dL or darker should not be processed by serology testing." The stem asks for the threshold shown on the palette, rather than whether a higher level is also unacceptable.

   Reference: CDC Reference Tool to Determine Hemolysis Status — How to use the palette

4. 4A unitized waived rapid test is read before the time specified in its insert. Which reaction problem explains a possible early false-negative result?

   1. A. The specimen has not fully reacted with test reagents
   2. B. The color reaction has developed beyond its intended endpoint
   3. C. The visible reaction product has faded after development
   4. D. The reaction has migrated beyond the visible read area

   Answer: A

   Explanation: "Insufficient timing can result in false negative or invalid results because the specimen might not react completely with test system reagents." CDC attributes exaggerated color, fading, and migration beyond the visible range to intervals longer than specified, not to an early read.

   Reference: CDC Good Laboratory Practices for Waived Testing Sites — Performing the Test, timing

5. 5A trainee reviewing urine formation asks which nephron structure initially filters small molecules and fluid from blood. Which structure is responsible?

   1. A. Glomerulus
   2. B. Renal tubule
   3. C. Ureter
   4. D. Urinary bladder

   Answer: A

   Explanation: "the glomerulus filters your blood, and the tubule returns needed substances to your blood and removes wastes." The glomerulus provides the initial filtration step.

   Reference: NIDDK Your Kidneys & How They Work — How do my kidneys work?

6. 6At a nonwaived laboratory, staff are consulting the documents that govern an assay. Which document does CLIA specifically require to be available to personnel and followed for every test performed there?

   1. A. The laboratory's written procedure manual
   2. B. The current manufacturer's package insert
   3. C. A published clinical laboratory standard
   4. D. A current laboratory medicine textbook

   Answer: A

   Explanation: "A written procedure manual for all tests, assays, and examinations performed by the laboratory must be available to, and followed by, laboratory personnel. Textbooks may supplement but not replace the laboratory's written procedures for testing or examining specimens." The local written manual is the document CLIA specifically requires staff to follow; the other documents may inform procedures but do not replace that manual.

   Reference: eCFR Title 42 Part 493 Laboratory Requirements — 42 CFR §493.1251(a)

7. 7A phlebotomist explains why blood can exchange dissolved substances with cells near a skin-puncture site. Which vessels primarily perform this exchange?

   1. A. Arteries
   2. B. Capillaries
   3. C. Venules
   4. D. Veins

   Answer: B

   Explanation: "The primary function of capillaries is the exchange of materials between the blood and tissue cells." The small exchange vessels at the tissues are capillaries, rather than the larger conducting vessels.

   Reference: Classification & Structure of Blood Vessels — Capillaries

8. 8A collection station receives a recurring standing order for a waived test. Which record establishes that the standing order actually exists?

   1. A. A documented authorized standing order
   2. B. A note that this test was done last visit
   3. C. A reminder that the next visit is due
   4. D. The patient's copy of preparation advice

   Answer: A

   Explanation: "Standing orders for certain tests might apply, but they should be documented." Prior testing, scheduling, and preparation advice are real records but do not document an authorized standing order.

   Reference: Good Laboratory Practices for Waived Testing Sites — Recommended Practices Before Testing, Test Orders

9. 9A noncatheterized patient is asked to provide a clean-catch urine specimen for bacterial culture. Which collection and container combination meets both the clean-catch instruction and the sterile-culture-container requirement?

   1. A. Midstream urine collected into a sterile cup
   2. B. First-stream urine collected into a sterile cup
   3. C. Midstream urine collected into a clean nonsterile cup
   4. D. First-stream urine collected into a clean nonsterile cup

   Answer: A

   Explanation: MedlinePlus instructs the patient to "urinate a small amount into the toilet bowl, then stop the flow of urine" before filling the cup. CMS lists "sterile containers for culture specimens". For this patient-collected clean-catch culture, the correct combination is midstream urine in a sterile cup; the other combinations change the stream portion or container sterility.

   Reference: MedlinePlus Clean Catch Urine Sample — How the Test is Performed, clean-catch urine collection

10. 10A waived point-of-care result conflicts with the patient's clinical information, and the discrepancy is still unresolved. Which reporting action follows CDC guidance?

    1. A. Withhold the result while repeating the test and resolving the discrepancy
    2. B. Release the first result as provisional while repeating the test
    3. C. Release the repeated result before reconciling it with the first
    4. D. Release the first result with an unresolved-discrepancy comment

    Answer: A

    Explanation: "If a discrepancy is identified between the patient's test results and the clinical information or if the results are invalid or otherwise compromised, testing should be repeated. Results should not be reported until the problem is resolved." The result remains withheld through repeat testing until the discrepancy is resolved.

    Reference: CDC Good Laboratory Practices for Waived Testing Sites — Resolving Problems