Chapter 31

You need to collect a venous blood specimen from a patient to run an FBG. What statement would be inappropriate to make to the patient during this procedure?

"This procedure will not hurt"

Your physician has requested an electrolyte profile on a patient. The laboratory directory indicates this test requires 4 mL of serum. Which tubes should be used to collect the specimen?

10-ml SST

Which of the following gauge needles is used most often to perform a routine venipuncture using the vacuum tube method?

21 G

The following techniques can be used to prevent a vein from rolling?

Applying firm pressure below and to the side of the vein

What is the proper method for identifying a patient before performing a venipuncture?

Ask the patient to state his or her full name and DOB

What may occur if the needle is removed from the arm before removing the tourniquet?

Bleeding may occur around the puncture site

An evacuated tube with a lavender stopper contains:

EDTA

How is serum obtained?

From clotted blood that has been centrifuged

What should be performed if an evacuated tube contains a clot activator?

Gently invert the tube five times after drawing it

The following is found in the serum of blood?

Glucose, hormones, chloride and antibodies

This may occur if a tourniquet is applied too tightly?

It may be uncomfortable for the patient, inaccurate test results may occur, arterial and venous blood flow may be obstructed

When collecting a venous blood specimen to be transported to an outside laboratory for testing, what should be consulted for information on collecting and handling requirements?

Laboratory directory

Which sites can be used to make a skin puncture on an adult?

Lateral part of the third fingertip

What color stopper tube is used to collect a blood specimen for a complete blood cell count (CBC)?

Lavender

What color stopper tube is used to collect a blood specimen for a prothrombin time test?

Light blue

Which antecubital veins are considered the best vein to use for a venipuncture?

Median cubital vein

The following are characteristics of the brachial artery (located in the antecubital space)?

Pulsates when palpated, has a more elastic and thicker wall than a vein, if punctured, blood is bright red in color and the patient will feel more than the usual amount of pain

Indicates the correct order of draw for the vacuum tube method of venipuncture?

Red, green, lavender, gray

The following evacuated tubes can be used to collect serum:

Red/gray, gold, red, and light blue

When performing a venipuncture, the following techniques represent a violation of the OSHA standard?

Removing the plastic holder from the needle for reuse

What should not be used as a venipuncture site?

Scarred skin, bruised skin, an area that is painful to the patient and burned skin

What position should be used for a venipuncture if a patient appears nervous or has fainted in the past from a venipuncture?

Semi-Flowler

What represents an error in technique when working with evacuated tubes?

Shaking a tube containing an anticoagulant after drawing it

The following veins are most likely to collapse when performing a venipuncture?

Small veins

What is a disadvantage of using the syringe method of venipuncture?

The amount of blood specimen that can be collected is limited by the size of the syringe

What may occur if an angle of less than 15 degrees is used to perform the venipuncture?

The needle may enter the skin above the vein and not puncture it

What may occur if an outdated evacuated tube is used to collect the blood specimen?

The tube may no longer have a vacuum

Why should the veins of the hands be used as a venipuncture site only as a last resort?

They have a tendency to roll, they are more difficult to stick, the procedure is more uncomfortable for the patient and the hand veins are more susceptible to collapsing

What may cause a result in hemolysis of the blood specimen?

Using a needle with a small lumen to collect the specimen

The following represents an error in technique when obtaining a capillary blood specimen?

Using the first drop of blood for the test

The following represents an error in technique when selecting a vein for venipuncture?

Using the thumb to palpate the vein

After drawing a blood specimen for an electrolyte profile, the next step is to:

allow the specimen to stand in an upright position for 30-45 minutes

The size of the evacuated tube you choose to obtain a venous blood specimen depends on the:

amount of specimen required for the test

Methods for performing venipuncture include:

butterfly method, syringe method and vacuum tube method

When performing a capillary puncture, the finger should not be squeezed to avoid:

diluting the blood sample with tissue fluid

During the venipuncture procedure, a sudden swelling occurs in the area around the puncture site. You should:

immediately remove the tourniquet and then the needle

Hemolysis of a blood specimen results in:

inaccurate test results

If a fibrin clot formed in the serum layer of a blood specimen, it would:

interfere with adequate serum collection

When collecting a blood specimen using the vacuum tube method of venipuncture, venous reflux is prevented by:

keeping the patient's arm in a downward position

A guideline that should not be followed when assembling equipment and supplies for a venipuncture are:

label each blood tube with one unique patient identifier

The purpose of applying a tourniquet when performing venipuncture is to:

make the patient's veins more visible and easier to palpate

What results in patient discomfort during the venipuncture procedure?

moving the needle after it has been inserted into the vein

What may occur if a finger puncture is made that is deeper than 3.1 mm?

penetration of the bone

An individual who collects blood specimens is known as a (n):

phlebotomist

The following are correct techniques for applying a tourniquet:

placing the tourniquet 3-4 inches above the bend in the elbow, asking the patient to clench their fist, and applying the tourniquet so that it is snug, but not tight

On standing, a blood specimen to which an anticoagulant has been added separates into:

plasma, buffy coat, and blood cells

You are performing a venipuncture, and the patient becomes dizzy and is about to faint. Your first priority in this situation should be to:

protect the patient from injury

Phlebotomy includes:

skin punctures, arterial punctures, and venipunctures

On palpation, a scarred vein feels:

stiff and hard

Plasma functions in:

transporting electrolytes needed by the cells, nutrients needed by the tissues, picks up wastes from the tissues and transports antibodies, enzymes and hormones

If you think a vein selected for venipuncture may collapse, you should:

use the butterfly method to perform the draw

Whole blood is obtained by:

using a tube containing an anticoagulant