Nokea
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.
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In what sequence will you draw the colored tubes?
- A. Yellow
- B. Lavender
- C. Green
- D. Gray
Correct Answer: A,B,C,D
Rationale: The order of draw is yellow (blood cultures) first to prevent contamination, followed by lavender (CBC), green (electrolytes), and gray (glucose) to minimize additive carryover.
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.
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.
When performing dermal punctures, what sites are commonly used in an infant, older child, and adult?
- A. Heel for infants, finger for older children and adults
- B. Earlobe for infants, finger for older children and adults
- C. Heel for infants, earlobe for older children, finger for adults
- D. Finger for all ages
Correct Answer: A
Rationale: The heel is used for infants due to safety and accessibility, while fingers are used for older children and adults for dermal punctures.
Why is it important that you tell the patient exactly what you are about to do before you begin?
- A. To gain the patient's cooperation
- B. To delay the start of the task
- C. To reduce patient anxiety
- D. To demonstrate your knowledge
Correct Answer: A,C
Rationale: Informing the patient about the procedure helps gain their cooperation and reduces anxiety by setting clear expectations and building trust.