Phlebotomy (CPT) guide · updated 2026-09-29

NHA CPT test plan: the five domains explained

The NHA CPT exam follows a test plan built on a 2024 job analysis and live since January 7, 2026. Its 100 scored items are split into Safety and Compliance (26), Patient Preparation (20), Routine Blood Collections (28), Special Collections (12) and Processing (14).

Summary table

Domain	Items	What it covers
1. Safety and Compliance	26	OSHA, CDC, CLSI and Joint Commission standards, HIPAA, quality control, sharps and biohazards, exposure control, PPE, first aid and CPR
2. Patient Preparation	20	Requisitions, patient ID, consent, communication, fasting and basal state, special considerations, positioning, site selection, non-blood specimen instructions
3. Routine Blood Collections	28	Equipment, tube colors and additives, order of draw, inversions, tourniquet, venipuncture technique, complications, capillary puncture, labeling
4. Special Collections	12	Blood cultures, blood donation, pediatric and geriatric volume limits, newborn screening, point-of-care tests, tolerance tests, blood alcohol, drug screens, swabs
5. Processing	14	Centrifuging, aliquoting, storage and transport, chain of custody, lab information systems, critical values, result distribution, recollection

Core knowledge that runs through every domain

Before the domains, the test plan lists core knowledge that can appear inside any item: medical terminology, blood components, ABO and Rh groups, the cardiovascular system, vascular anatomy of the antecubital fossa, hand and foot, hemostasis, pre-analytical errors, aseptic technique, standard precautions, the Needlestick Safety and Prevention Act, HIPAA, the Patient Bill of Rights, communication, professionalism, EMR use, labeling and documentation.

In practice this means a question filed under Processing can still hinge on knowing that serum comes from a clotted tube and plasma from an anticoagulated one.

Domain 1: Safety and Compliance (26 items)

The second biggest domain. Expect questions on which agency sets which rule, what to do right after a needlestick, how to dispose of a used needle with its holder, the order for donning and doffing PPE, airborne versus droplet versus contact precautions, and quality control logs for refrigerators and point-of-care analyzers. First aid for fainting and excessive bleeding also sits here.

Domain 2: Patient Preparation (20 items)

Everything before the needle: reading the requisition, confirming identity with at least two identifiers, types of consent, when a guardian must consent, fasting and timed draws, and which arm you may not use (for example the side of a mastectomy or an arm with a fistula). It also includes matching a test to its tube color and teaching patients to collect urine, stool, sputum or semen.

Domain 3: Routine Blood Collections (28 items)

The largest domain and the core of the job. Order of draw is the single most tested idea, followed by tube additives, the number of inversions, tourniquet time, needle angle, what to do when no blood flows, and how to respond to a hematoma, nerve pain or a patient who faints. Capillary puncture sites, depth and the capillary order of draw are here too.

Domain 4: Special Collections (12 items)

Small but wide. Blood culture skin prep and bottle order, blood donor screening, filter paper newborn screening, point-of-care glucose and hemoglobin, glucose tolerance test timing, blood alcohol collection (no alcohol prep pad), and drug screen collection rules. The test plan explicitly includes calculating or looking up the most blood you can safely take from a pediatric or geriatric patient.

Domain 5: Processing (14 items)

What happens after the draw: letting a serum tube clot before centrifuging, balancing the centrifuge, aliquoting, which specimens go on ice, which must be kept warm or protected from light, chain of custody, lab information system entries, reporting critical point-of-care values and when a specimen must be recollected.

How to use the weights

Put study time roughly in proportion: about half on domains 1 and 3 together (54 items), a fifth on patient preparation, and the rest split between special collections and processing. Every practice question on this site is tagged to one of these five domains, so your results page shows the same split the real score report uses.

Sample Phlebotomy (CPT) questions with answers

1. Under the OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030), how often must an employer review and update the written Exposure Control Plan?

Every 6 months
At least annually and whenever new or modified tasks or procedures affect occupational exposure
Every 2 years
Only after a documented needlestick or splash exposure incident

Show answer

B. At least annually and whenever new or modified tasks or procedures affect occupational exposure The OSHA Bloodborne Pathogens Standard requires the written Exposure Control Plan to be reviewed and updated at least annually and whenever new or modified tasks or procedures create or change occupational exposure risk. A 6-month cycle is not the regulatory requirement. A 2-year interval is insufficient to meet the standard. Waiting for an exposure incident would leave workers unprotected and does not satisfy the proactive review obligation.

2. A phlebotomist and a colleague discuss a patient's name and diagnosis while riding a public elevator. Which HIPAA rule does this MOST directly violate?

The Security Rule, because the conversation transmits electronic protected health information
The Breach Notification Rule, because the employer must notify HHS within 60 days
The Privacy Rule, because patient-identifiable health information was disclosed in an unsecured setting
The Enforcement Rule, because automatic civil penalties apply to any verbal disclosure

Show answer

C. The Privacy Rule, because patient-identifiable health information was disclosed in an unsecured setting Verbally disclosing a patient's name and diagnosis in a semi-public area is an impermissible disclosure of protected health information (PHI) under the HIPAA Privacy Rule. The Security Rule governs safeguards for electronic PHI only, not verbal disclosures. The Breach Notification Rule applies to specific reportable breaches of unsecured PHI, not every privacy policy violation. The Enforcement Rule describes how HHS investigates complaints and assesses penalties; it does not define what constitutes a violation.

3. Which temperature range is acceptable for a laboratory refrigerator used to store blood specimens and CLIA-waived test reagents?

-20°C to -15°C
2°C to 8°C
10°C to 15°C
15°C to 25°C

Show answer

B. 2°C to 8°C The accepted range for a laboratory reagent and specimen refrigerator is 2°C to 8°C (36°F–46°F), consistent with CLIA and manufacturer guidelines. Temperatures below 2°C risk freezing liquid specimens and reagents, altering their integrity. -20°C to -15°C describes a standard laboratory freezer, not a refrigerator. Ranges of 10–15°C or 15–25°C are too warm and accelerate reagent degradation.

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Sources: NHA CPT Test Plan (2024 job analysis, exam live January 7, 2026) · NHA: New CPT certification exam and study materials. Independent study material. Not affiliated with or endorsed by the National Healthcareer Association.

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NHA and National Healthcareer Association are trademarks of the National Healthcareer Association. ExamWeight is an independent study resource and is not affiliated with, endorsed by, or sponsored by NHA. Questions are original and written against the published Certified Phlebotomy Technician (CPT) test plan.