Patient Preparation

20% of the CPT · blueprint NHA CPT Test Plan, based on a job analysis completed in 2024

Short answer

Twenty of the 100 scored items. It covers communication and cultural competence, obtaining and verifying the requisition, positive patient identification, the forms of consent including consent from a legal guardian, insurance and billing, verifying fasting and medication compliance, interviewing for allergies and a history of fainting, positioning, and determining the venipuncture site against CLSI standards.

Why it matters on this exam

Twenty items, and the domain where the highest-consequence error in phlebotomy lives: drawing the right blood from the wrong patient. Everything in this domain happens before the needle.

Key concepts

Patient identification (2E, k41). Positive identification using specific identifiers while following HIPAA guidelines. Asking a patient to confirm their own name and date of birth is the method; reading it off the wristband and asking "are you Mr Smith?" is not.
The requisition (2C, k42). Obtain, review and verify it. Know the required fields: patient demographics, physician information, diagnosis code, tests ordered and test priority. Recognise STAT versus routine versus timed draws (k45).
Consent (2F, 2G, k43). Implied, informed and expressed consent, and when permission must come from a legal guardian — children, patients with dementia or mental disabilities.
Communication (2A, 2B, 2D, k40, k15, k16). Open-ended questions and empathetic listening; introducing yourself by name, title and department; and the patient characteristics that affect communication — cultural differences, language barriers, cognitive level, developmental stage, hearing impairment. Core Knowledge k18 names gender identity and expression, and pronoun use explicitly.
Test preparation compliance (2K, k46). Fasting, medication and basal state requirements, and what to do when the patient has not complied.
The interview (2L, k48, k49). Allergies, medications, recent surgeries, history of fainting. Then the special considerations: age, physical and mental condition, presence of fistulas.
Site determination (2O). The test plan says this is done "based on established Clinical and Laboratory Standards Institute standards, to minimize patient risk and optimize outcome" — CLSI, named by NHA.
Tube-to-test matching (k47). Which collection tube colour matches which laboratory test, with blue stopper for coagulation given as the example.
Volume (k51) and positioning (2N, k52). Minimum and maximum blood volume requirements; positioning to maximise comfort and safety.
Non-blood specimens (2P, k50) — instructing patients on stool, urine, semen and sputum collection — and EMR/EHR entry (2Q).

Common mistakes

Verifying identity against the requisition alone. The requisition is one half; the patient actively stating their identifiers is the other.
Proceeding after a fasting failure without documenting it. Task 2K is to verify compliance and proceed accordingly, which includes escalating and recording, not silently drawing.

Worked example

A patient with an arteriovenous fistula in the left arm arrives for a routine draw. Two things in this domain fire at once. Knowledge statement k49 lists the presence of fistulas among the special considerations that may impact collection, so the fistula arm is not a site. And task 2O requires site determination against CLSI standards to minimise patient risk — so the correct response is to assess the other arm, not to work around the fistula. The interview at task 2L is what surfaces this before you ever pick up a tourniquet.

Original practice questions

Patient PreparationDifficulty 3/5

What is the correct way to positively identify an inpatient before a draw?

AConfirm the room and bed number against the requisition before approaching
BAsk the nurse on duty to confirm the identity of the patient being drawn
CAsk the patient to state their identifiers and match them to the requisition
DRead the name from the wristband and ask the patient to confirm it is correct

Show answer and rationale

Correct: C. The patient states their own identifiers and you match them; that is what makes the identification positive. Reading a name and inviting agreement lets a confused or hard-of-hearing patient assent to the wrong one.

D — Asking a patient to confirm a name you supplied invites a false yes rather than testing identity.
A — Room and bed numbers change and are not patient identifiers.
B — Delegating identification does not satisfy the phlebotomist's own verification obligation.

Patient PreparationDifficulty 3/5

A patient with dementia cannot give verbal or expressed consent. What does the test plan require?

AProceed on the basis of implied consent because the patient is hospitalised
BAsk another member of staff to witness and countersign the requisition
CPostpone the draw indefinitely until the patient regains full capacity
DObtain permission from the legal guardian before proceeding with the draw

Show answer and rationale

Correct: D. Task 2G requires obtaining permission from a legal guardian when the patient cannot give verbal or expressed consent, naming children and patients with dementia or mental disabilities.

A — Implied consent does not substitute for guardian permission where capacity is absent.
B — A staff witness does not supply the consent that the guardian is required to give.
C — Postponing indefinitely denies necessary care rather than following the consent pathway.

Patient PreparationDifficulty 3/5

A patient has an arteriovenous fistula in the left arm. How does this affect site selection?

AThe fistula arm is avoided and an alternative site is assessed instead
BThe fistula arm is used below the fistula to avoid disturbing it directly
CThe fistula arm is used with a smaller gauge needle than would be usual
DThe fistula arm is used only when the tourniquet is applied above it

Show answer and rationale

Correct: A. Knowledge statement k49 lists the presence of fistulas among the special considerations affecting collection, and task 2O requires site determination against CLSI standards to minimise patient risk.

B — Drawing anywhere in the fistula limb risks the access the patient depends on.
C — Needle gauge does not make the fistula limb an acceptable site.
D — Applying a tourniquet to a fistula limb is itself contraindicated.

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4 flashcards for Patient Preparation

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Primary references

NHA Certified Phlebotomy Technician (CPT) — Test Plan for the CPT Exam — National Healthcareer Association (NHA) · primary · retrieved 2026-09-22, verified 2026-09-22

Last reviewed: 2026-09-22Next review by: 2026-11-06Draft — pending editorial reviewHow we verify facts