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Phlebotomy practice questions for the CCMA exam

Phlebotomy is 12 of the 150 scored questions (8%) on the CCMA exam, part of Clinical Patient Care (84 questions). Try 5 free questions below; open each one to see the answer, why the other options are wrong and the sources.

Question 1

A reference laboratory's directory lists a test as "serum, frozen." The medical assistant has a centrifuged gold tube. What is the best way to prepare it?

  1. Refrigerate the gold tube and ship it with a cold pack
  2. Ship the gold tube at room temperature by the fastest courier
  3. Freeze the whole gold tube with the cells still in it
  4. Aliquot the serum into a labeled tube and ship it frozen
Show answer and explanation

Correct answer: D. Aliquot the serum into a labeled tube and ship it frozen

Specimens must be stored and transported under the conditions the performing laboratory specifies. When frozen serum is required, the serum is separated into a labeled transfer tube and kept frozen until it arrives.

Why the other options are wrong

  • A. Refrigerate the gold tube and ship it with a cold pack: Refrigeration does not meet a frozen requirement.
  • B. Ship the gold tube at room temperature by the fastest courier: Room temperature does not meet a frozen requirement, however fast the courier is.
  • C. Freeze the whole gold tube with the cells still in it: The directory calls for serum, which must be removed from the cells before freezing.

Sources

Question 2

A reference laboratory's requisition asks for a diagnosis code. Where does the medical assistant get the diagnosis?

  1. From the code that best fits the patient's insurance plan
  2. From the patient's own description of the symptoms
  3. From the reference laboratory's list of covered codes
  4. From the ordering provider's order and documentation
Show answer and explanation

Correct answer: D. From the ordering provider's order and documentation

Diagnostic laboratory tests must be ordered by the treating provider, who keeps the documentation of medical necessity. The MA transfers the diagnosis the provider documented and does not choose one to fit coverage.

Why the other options are wrong

  • A. From the code that best fits the patient's insurance plan: Choosing a code to fit coverage is improper; the provider's documentation drives the code.
  • B. From the patient's own description of the symptoms: Assigning a diagnosis from the patient's description is outside the MA's role.
  • C. From the reference laboratory's list of covered codes: A list of covered codes does not tell what this patient's diagnosis is.

Sources

Question 3

Which additive prevents clotting by inhibiting thrombin rather than by binding calcium?

  1. Heparin
  2. Potassium EDTA
  3. Plastic-tube clot activator
  4. Sodium citrate
Show answer and explanation

Correct answer: A. Heparin

WHO describes heparin as inactivating thrombin and thromboplastin. Citrate and EDTA instead remove calcium by forming calcium salts.

Why the other options are wrong

  • B. Potassium EDTA: EDTA chelates calcium.
  • C. Plastic-tube clot activator: A clot activator speeds clotting; it is not an anticoagulant.
  • D. Sodium citrate: Citrate binds calcium.

Sources

Question 4

How should a patient be positioned for a routine venipuncture?

  1. Seated on the edge of the exam table, legs hanging
  2. Seated on a high stool with no back support
  3. Standing with the arm resting on a counter
  4. Seated in a chair with an armrest, or lying down
Show answer and explanation

Correct answer: D. Seated in a chair with an armrest, or lying down

Venipuncture is always done with the patient sitting in a chair with arm support or lying down. A patient who faints while standing or on a stool can be seriously hurt.

Why the other options are wrong

  • A. Seated on the edge of the exam table, legs hanging: The edge of a table gives no protection from a fall.
  • B. Seated on a high stool with no back support: A stool gives no support if the patient faints.
  • C. Standing with the arm resting on a counter: A standing patient who faints can fall and be injured.

Sources

Question 5

Under CLIA, to which laboratories may specimens be referred for testing?

  1. To any laboratory that offers the lowest price for the test
  2. To any laboratory listed in an online search engine
  3. To any laboratory that the patient chooses, certified or not
  4. Only to CLIA-certified or equivalent laboratories
Show answer and explanation

Correct answer: D. Only to CLIA-certified or equivalent laboratories

CLIA states that a laboratory must refer specimens for testing only to a CLIA-certified laboratory or one that meets equivalent requirements as determined by CMS.

Why the other options are wrong

  • A. To any laboratory that offers the lowest price for the test: Price does not make a laboratory eligible.
  • B. To any laboratory listed in an online search engine: An online listing does not show certification.
  • C. To any laboratory that the patient chooses, certified or not: Certification is required regardless of who chooses the laboratory.

Sources

Cheat sheets for this topic

Phlebotomy terms

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