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Loss of flow after an initial tube may indicate the bevel is pressed against the vein wall or the vein has collapsed. The safest first maneuver is to withdraw the needle slightly (1–2 mm) while keeping the angle and alignment; this re-centers the bevel in the lumen, often restoring flow. Option B is the standard initial correction. Upsizing the needle (Option A) increases trauma without addressing alignment. Removing and re-entering the same site (Option C) raises hematoma risk and should be avoided; if necessary, stop, apply pressure, and choose a different site after hemostasis. Over-tightening the tourniquet (Option D) can worsen hemoconcentration and collapse fragile veins. Also check tube vacuum by trying a new tube, ensure the needle is fully seated in the holder, and confirm the tourniquet has been released before removing the needle. Systematic troubleshooting preserves vein integrity, minimizes patient discomfort, and supports high first-attempt success—skills emphasized in certification testing.