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ASCP MLA Exam: Practice Questions

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ASCP MLA Exam: Practice Questions

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400
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About these practice questions

These practice questions will help you prepare for the ASCP MLA exam.

This practice test contains 400 practice questions covering the five sections of the ASCP MLA exam:

  1. Patient registration and specimen collection
  2. Specimen preparation and processing
  3. Support for clinical testing
  4. Waived and point-of-care testing
  5. Laboratory operations

All questions have been carefully designed to reflect the questions on the real exam, to help you prepare and get a passing grade.

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Sample practice questions

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Section 1: Patient registration and specimen collection

1) Which specimen request has the highest priority?
  1. Fasting
  2. Post-op
  3. Stat
    Tests that are "stat" (from the Latin word statim, meaning “immediately”) have the highest priority. These tests are needed for the immediate management of life-threatening situations.
  4. Timed
2) You must collect specimens from three patients: a fasting specimen, a pre-op specimen, and a routine specimen. What is the correct order of priority for collecting these specimens?
  1. Fasting, Pre-op, Routine
  2. Fasting, Routine, Pre-op
  3. Pre-op, Fasting, Routine
    Pre-operative (pre-op) tests are done before surgery. Therefore, they have the highest urgency, because delays to these tests will delay surgery. Fasting tests are next because patients cannot eat until the specimens have been taken. Routine specimens are last as they have no urgency.
  4. Routine, Fasting, Pre-op
3) A patient has a latex allergy. A phlebotomist needs to collect a specimen from another patient in the same room. How should the phlebotomist proceed?
  1. Ask the allergic patient to wear a mask
  2. Do not take anything that contains latex into the room
    When dealing with a patient with a latex allergy, it is crucial to avoid exposing the patient to anything made of latex. The safest approach is to ensure no latex-containing items are brought into the room.
  3. Proceed as usual
  4. Pull the curtain between beds and proceed as usual
4) What should you do when drawing blood from a frightened child?
  1. Explain the procedure in simple terms
    When drawing blood from a scared child, explain the procedure in simple terms. Be honest with the child; don't lie by telling them the needle won't hurt. Having the parent hold the child can also help comfort them.
  2. Say nothing and just perform the procedure
    Saying nothing can be frightening for a child; it's important to communicate to reduce their anxiety.
  3. Tell the child that the needle won't hurt
    Telling the child the needle won't hurt can erode the child's trust when they do experience pain.
  4. Tell the child to be brave
    Telling the child to be brave can add pressure and anxiety, making the child more nervous.
5) You have to draw blood from a nervous patient. What should you do?
  1. Be friendly and confident
    When dealing with a nervous patient, being friendly and confident can help alleviate their anxiety.
  2. Cancel the requisition and send them home
  3. Tell the patient the needle won't hurt
    Telling a patient the needle won’t hurt can reduce the patient's trust if they do feel pain.
  4. Tell the patient to calm down
6) A phlebotomist must collect an urgent blood sample, but the patient is asleep. What should the phlebotomist do?
  1. Cancel the test
  2. Come back later when the patient is awake
  3. Draw the sample while the patient is asleep
    Never collect a blood specimen from a sleeping patient: doing this would not only disregard the patient's right to informed consent, but could also injure the patient if the patient wakes up suddenly during the blood draw.
  4. Wake up the patient
    In this situation, the phlebotomist should wake the patient, since the blood sample is urgent.
7) A phlebotomist needs to collect a blood specimen from an inpatient who is not wearing an ID band. What is the best action to take?
  1. Ask the nurse to confirm the identity of the patient
  2. Do not draw the specimen until an ID band is placed
    Inpatients must be identified using the details on their ID band. If the patient is not wearing an ID band, do not collect the specimen. Instead, notify the nurse so a new ID band can be placed. The other options are wrong because you shouldn't rely on verbal confirmation, nurse confirmation, or name cards to identify a patient.
  3. Identify the patient by asking them, "What is your name?"
  4. Identify the patient by the name card on the door
8) When drawing blood from an obese patient, where should you first look for a vein?
  1. The antecubital fossa
    The antecubital fossa is the first choice for blood collection in most patients, including obese patients. The median cubital vein, located in the antecubital fossa, is usually the easiest and safest vein to access.
  2. The back of the knee
  3. The feet
  4. The neck
9) What can a phlebotomist do to find a difficult vein?
  1. Apply the tourniquet tightly for 3 to 4 minutes
  2. Ask the patient to hold their arm up
    Asking the patient to hold their arm up would drain the arm of blood and make the veins harder to find.
  3. Ask the patient to make a fist
    Making a fist makes the veins more prominent by increasing blood flow to the area. This is a standard technique used by phlebotomists during venipuncture.
  4. Cool the area with an ice pack
    Cooling the area with an ice pack would make the veins constrict, making them harder to find. Warming the area with a heating pad is the correct approach.
10) A patient has an IV in his left wrist and a cast on his right arm. Which site should be used to obtain a venous blood sample?
  1. A vein in the left forearm
  2. A vein in the left hand
    The right arm cannot be used due to the cast. Therefore, the blood must be drawn from the left arm. However, blood should not be drawn from above the IV because the IV fluid could contaminate the blood sample. Therefore, the best place to draw blood is the left hand (below the IV site).
  3. A vein in the right forearm
  4. An earlobe
11) A patient has a mastectomy on her right side. What special precaution is needed when drawing blood from this patient?
  1. Check the patient's white blood cell count
  2. Do not draw blood from the right arm
    It's generally not recommended to draw blood from an arm on the same side as a mastectomy.
  3. Make sure the patient is lying down
  4. Make sure the patient is sitting
12) Which vein should be tried first when choosing a draw site?
  1. Basilic
  2. Cephalic
  3. Median antebrachial
  4. Median cubital
    The median cubital vein is preferred for venipuncture because it is large, easy to access, and unlikely to roll around.
13) Which letter is pointing to the median cubital vein?
  1. a
    The median cubital vein is labelled "a" in the image. It is located inside the elbow. It is the first choice for venipuncture due to its size and accessibility. The vein labelled "b" is the basilic vein. It is found on the medial (pinky side) aspect of the arm. The vein labelled "c" is the cephalic vein. This vein runs along the lateral (thumb side) aspect of the arm. The vein labelled "d" is the median antebrachial vein. It runs along the center of the forearm. The image below shows the labelled veins.
  2. b
  3. c
  4. d
14) For venipuncture, tourniquets should be:
  1. applied very tightly to the arm
  2. left on the arm for at least three minutes
    Leaving the tourniquet on for three minutes could cause blood pooling at the venipuncture site, leading to falsely elevated results.
  3. tight enough to slow arterial flow
  4. tight enough to slow venous flow
    The tourniquet should be tight enough to slow venous flow without affecting the arterial flow.
15) In venipuncture, what can happen if you palpate a site after cleaning it with alcohol?
  1. Difficulty locating the vein
  2. Entry of alcohol into the patient's bloodstream
  3. Hemolysis of the specimen
  4. Recontamination
    Alcohol is used to kill microorganisms on the skin before inserting the needle. If you touch the site again after cleaning, your fingers can transfer bacteria or other contaminants back to the area. This recontaminates the site, increasing the risk of infection or invalid test results. If you must palpate the vein again, you should first sanitize your fingers with an alcohol pad, or clean the site again after touching it.
16) Why must you clean the patient's skin before venipuncture?
  1. To increase blood flow
  2. To make the veins more prominent
  3. To prevent clotting
  4. To remove microorganisms
    Cleaning the patient's skin before venipuncture removes surface bacteria, helping to prevent infection.
17) What is the purpose of a tourniquet in venipuncture?
  1. To decrease the oxygen level
  2. To make the veins more prominent
    Tourniquets restrict blood flow in the arm, making the veins more prominent and accessible.
  3. To monitor blood pressure
  4. To prevent hematoma
18) After applying a tourniquet, small red spots appear on the patient's arm. These spots are a sign that:
  1. the patient has diabetes
  2. the patient is taking an anticoagulant
  3. the site may bleed excessively
    Tiny, non-raised red spots that appear on the patient’s skin when a tourniquet is applied are called petechiae. They indicate the venipuncture site may bleed excessively. They do not indicate that the phlebotomist has performed the procedure incorrectly.
  4. the tourniquet is too tight
19) For venipuncture, the tourniquet should be applied _____________ the needle insertion point.
  1. 1–2 inches above
  2. 1–2 inches below
  3. 3–4 inches above
    Tourniquets should be applied 3–4 inches above the needle insertion site. This positioning helps make the veins more prominent.
  4. 3–4 inches below
20) What can happen if a phlebotomist removes the needle before releasing the tourniquet?
  1. Angina
  2. Bleeding
    If the needle is removed before the tourniquet, the puncture site will bleed. For this reason, you should remove the tourniquet first, then the needle.
  3. Cyanosis
  4. Edema

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About the ASCP MLA exam

What is the ASCP MLA exam?

The ASCP Medical Laboratory Assistant (MLA) exam assesses the knowledge required for entry-level laboratory roles. The American Society for Clinical Pathology (ASCP) administers the exam. Successful candidates are awarded ASCP MLA certification, which can result in improved job prospects and a higher salary.

The exam consists of 100 multiple-choice questions and lasts 2 hours and 30 minutes. The exam fee is $145.

Exam eligibility

The ASCP MLA exam has six eligibility routes. These six routes are:

  1. High school graduation and completion of a Clinical Assistant program
  2. High school graduation and completion of a 50-week US military medical laboratory training course
  3. High school graduation and two years experience working as a laboratory assistant
  4. An associate degree and one year experience working as a laboratory assistant
  5. PBT certification and one year experience working as a laboratory assistant
  6. High school graduation, completion of a two-part MLA program, and six months experience working as a laboratory assistant

To take the ASCP MLA exam, candidates must meet the criteria for at least one of these routes.

[ASCP applying and taking]

Structure of the ASCP MLA exam

The questions on the ASCP MLA exam encompass five content areas:

  1. Patient registration and specimen collection
  2. Specimen preparation and processing
  3. Support for clinical testing
  4. Waived and point-of-care testing
  5. Laboratory operations

1. Patient registration and specimen collection

The first content area, Patient registration and specimen collection, is worth 20-25% of the ASCP MLA exam. It will ask you questions about:

  • Reviewing and clarifying orders
  • Identifying patients
  • Communicating with patients
  • Phlebotomy
  • Other collection procedures (e.g. urine, respiratory)
  • Labelling specimens
  • Billing and coding procedures

2. Specimen preparation and processing

The second content area, Specimen preparation and processing, is worth 30-35% of the exam and will ask you questions about:

  • Acceptability for testing
  • Specimen prioritization
  • Processing (e.g. centrifugation)
  • Storage of specimens
  • Transport of specimens

3. Support for clinical testing

The third content area, Support for clinical testing, is worth 20-25% of the exam and will ask you questions about:

  • Slides (including staining)
  • Microscopes
  • Reagents
  • Dilutions
  • Quality control

4. Waived and point-of-care testing

The fourth content area, Waived and point-of-care testing, is worth 5-10% of the exam and will ask you questions about:

  • Waived testing (e.g., glucose, pregnancy, urine dipstick)
  • Point-of-care testing (e.g. glucose, coagulation)

5. Laboratory operations

The final content area, Laboratory operations, is worth 10-15% of the exam and will ask you questions about:

  • Laboratory regulations (e.g. OSHA, TJC, CLSI, CDC)
  • Safety
  • Waste disposal
  • Laboratory equipment
  • Ethics

Recommended study resources

ASCP recommends the following resources for studying for the MLA exam:

  • Becan-McBride, K., & Garza, D. (2020). Success! in phlebotomy: A Q&A exam review (8th ed.). Pearson Education, Inc.
  • Estridge, B. H., & Reynolds, A. P. (2011). Basic clinical laboratory techniques (6th ed.). Delmar Cengage Learning.
  • Garza, D., & Becan-McBride, K. (2018). Phlebotomy Handbook: Blood specimen collection from basic to advanced (10th ed.). Pearson Health Science.
  • McCall, R. E. (2023). Phlebotomy Essentials (8th ed.). Jones & Bartlett Learning.
  • McCall, R. E. (2023). Phlebotomy Essentials exam review (8th ed.). Jones & Bartlett Learning.
  • Strasinger, S. K., & Di Lorenzo, M. S. (2019). The phlebotomy textbook (4th ed.). F.A. Davis Company.
  • Turgeon, M. L. (2022). Clinical laboratory science: Concepts, procedures, and clinical applications (9th ed.). Elsevier.