Nokea
What action(s) will help to protect you from bloodborne pathogens during phlebotomy?
- A. Washing your hands prior to the procedure
- B. Washing your hands after the procedure
- C. Wearing gloves during the procedure
- D. Activating the needle safety device immediately after removing your gloves
Correct Answer: A,B,C
Rationale: Hand washing before and after the procedure and wearing gloves during it are standard precautions to protect against bloodborne pathogens. The needle safety device should be activated immediately after use, not after removing gloves.
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You are performing phlebotomy on an elderly patient using a needle and syringe setup. Besides hemolysis, what can happen if you pull the plunger back too rapidly?
- A. Vein collapse
- B. Excessive bleeding
- C. Needle dislodgement
- D. Pain or discomfort
Correct Answer: A
Rationale: Pulling the plunger back too rapidly can create excessive negative pressure, causing the vein to collapse, especially in elderly patients with fragile veins.
Which of the following statements is(are) true regarding the correct techniques for phlebotomy?
- A. The maximum length of time you may leave a tourniquet in place on the patient's arm is 3 minutes.
- B. The tourniquet should be applied 6 to 8 inches above the proposed puncture site.
- C. The labels should be applied to the tubes prior to filling them with blood.
- D. If the patient's skin is fragile, you should apply the tourniquet over the gown or shirt sleeve to prevent skin tears.
Correct Answer: C,D
Rationale: Labels should be applied before filling tubes to ensure accuracy, and applying a tourniquet over clothing protects fragile skin. The tourniquet should not be left on for more than 1 minute, and it is typically applied 3-4 inches above the site.
You should avoid which of the following actions that can cause hemolysis?
- A. Using a 20- or 22-gauge needle and syringe
- B. Leaving the tourniquet on longer than 1 minute
- C. Using an evacuated tube set and a 25-gauge needle
- D. Withdrawing the blood slowly when using a needle and syringe
Correct Answer: B,C
Rationale: Leaving the tourniquet on too long or using a small-gauge needle (e.g., 25-gauge) with an evacuated tube can cause hemolysis due to excessive pressure or shear stress on red blood cells.
Explain the purpose of applying a tourniquet for phlebotomy.
- A. To restrict blood flow
- B. To dilate veins for easier access
- C. To prevent hemolysis
- D. To stabilize the needle
Correct Answer: B
Rationale: A tourniquet is applied to temporarily restrict venous blood flow, causing veins to dilate and become more visible and accessible for phlebotomy.
There are several tips you may use to find a suitable vein for venipuncture. Which of the following techniques is inappropriate?
- A. Have the patient hang the proposed arm dependently to allow blood to better fill the veins of the arm.
- B. Use an alcohol swab to apply rubbing friction in an attempt to stimulate the vein to distend.
- C. Using your fingers, slap the skin over the vein in an attempt to stimulate the vein to distend.
- D. Apply a warm pack to the site for 5 to 10 minutes to dilate the vein.
Correct Answer: C
Rationale: Slapping the skin is inappropriate as it may cause discomfort or bruising and is not a standard technique for vein distension.