Blood - Lab

The nurse is caring for a client who needs venipuncture. The client has IV fluids running in the left forearm. The client asks where the nurse will perform the venipuncture. What is the best response by the nurse? - "Anywhere in the left arm." - "Anywhere in the right arm." - "Anywhere above the IV in the left arm." - "Anywhere below the IV in the left arm."

"Anywhere in the right arm."

The nurse is caring for a female client who needs venipuncture. The client has a history of breast cancer. What is an important assessment question for the nurse? - "Have you been diagnosed with anemia?" - "Have you had a mastectomy?" - "Have you had chemotherapy?" - "Have you had a recent fever?"

"Have you had a mastectomy?"

The nurse is preparing to perform venipuncture to obtain a venous blood sample. Place the following steps in the correct order. - Reapply a tourniquet 3 to 4 in (3.75 to 10 cm) above the puncture site. - Insert the needle, bevel up, at a 15-degree angle. - Release tourniquet when blood flows into collection tube. - Hold the client's arm in a downward position. - Clean client's skin with antimicrobial swab. - Apply gentle pressure to the puncture site.

1)Clean client's skin with antimicrobial swab. 2)Reapply a tourniquet 3 to 4 in (3.75 to 10 cm) above the puncture site. 3)Hold the client's arm in a downward position. 4)Insert the needle, bevel up, at a 15-degree angle. 5)Release tourniquet when blood flows into collection tube. 6)Apply gentle pressure to the puncture site.

The nurse must obtain a venous blood specimen for culture and sensitivity. The client is very anxious about having the procedure and wants to know each step beforehand. When explaining the procedure, where will the nurse tell the client that the tourniquet will be placed? - 1 to 2 in (2.5 to 5 com) above the selected site - 3 to 4 in (7.5 to 10 cm) below the selected site - 3 to 4 (2.5 to 5 com) above the selected site - 1 to 2 in (2.5 to 5 com) below the selected site

3 to 4 (2.5 to 5 com) above the selected site

The nurse is collecting a blood sample from a central venous access device (CVAD). How much blood should the nurse collect in the discard tube? - 2 mL - 4 mL - 1 mL - 5 mL

5 mL

The nurse is inserting normal saline into the lumen of a central venous access device (CVAD) prior to obtaining a blood sample. What recommended amount of saline should the nurse use to flush the line? - 15 to 20 mL - 1 to 5 mL - 10 to 15 mL - 5 to 10 mL

5 to 10 mL

The nurse is caring for a client who is receiving total parenteral nutrition. While changing the dressing of the client's central venous access device (CVAD), the nurse cleanses the site with chlorhexidine. Which action would the nurse perform next? - Apply the transparent site dressing or securement/stabilization device over the insertion site. - Apply skin protectant to the same area, applying it directly on insertion site. - Wipe or blot the area with a sterile gauze pad and allow it to dry completely. - Apply skin protectant to the same area, avoiding direct application to the insertion site.

Apply skin protectant to the same area, avoiding direct application to the insertion site.

The nurse is providing care for several clients on a busy floor. The nurse receives a prescription to administer a transfusion of packed red blood cells for a client with decreased hemoglobin. Which action should the nurse take before entering the client's room to begin the transfusion? - Verify the client's name and date of birth with another nurse. - Review the client's most recent vital signs. - Arrange for another nurse to monitor the nurse's other assigned clients. - Prime the blood administration set with dextrose 5% normal saline solution.

Arrange for another nurse to monitor the nurse's other assigned clients.

The nurse, drawing a blood sample from a client's central venous access device (CVAD), is unable to start the blood flow, despite trying a new specimen tube. What would the nurse do next to try to start blood flow? - Flush the tubing with saline solution. - Encourage the client to place the arm below the level of the heart. - Ask the client to raise the arm and cough. - Flush the lumen with heparin.

Ask the client to raise the arm and cough.

After the venipuncture site has been selected and disinfected, what should the nurse do next? - Quickly proceed with needle puncture before the cleaning solution has dried. - Remove the tourniquet and proceed with the needle puncture. - Avoid touching the clean site prior to needle puncture. - Repalpate the venous site before needle puncture.

Avoid touching the clean site prior to needle puncture.

When preparing to change the dressing of a multiple lumen central venous access device (CVAD), which action does the nurse take to prevent air embolism? - Clamp each lumen - Flush each lumen with 10 milliliters normal saline - Put on sterile gloves - Place the client in an upright position

Clamp each lumen

The nurse is collecting a blood sample from a client's central venous access device (CVAD). The nurse notices that the flow stops when drawing the blood, even after changing the specimen tube and having the client cough. What would be the next recommended intervention? - Unclamp the tubing, remove the tube and vacutainer, and flush with normal saline. - Unclamp the tubing, remove the tube and vacutainer, and flush with heparin. - Clamp the tubing, remove the tube and vacutainer, and flush with heparin. - Clamp the tubing, remove the tube and vacutainer, and flush with normal saline.

Clamp the tubing, remove the tube and vacutainer, and flush with normal saline.

A nurse is collecting a venous blood specimen from an adult for culture and sensitivity. Which actions should the nurse perform? Select all that apply. - Collect blood-culture specimens before other specimens. - Collect the specimens at two different times. - Collect the specimens from two different sites. Insert the needle into the vein at a 45-degree angle to the skin. - Clean the client's skin at the puncture site with an antimicrobial swab. - Collect two bottles of specimen, totalling 30 mL.

Collect blood-culture specimens before other specimens. Collect the specimens from two different sites. Clean the client's skin at the puncture site with an antimicrobial swab. Collect two bottles of specimen, totalling 30 mL.

The nurse is assuming care for a client who is receiving an infusion of packed red blood cells (PRBCs). The PRBCs were hung 4 hours ago, and 100 mL is left to infuse. Which action is most appropriate? - Continue to infuse the PRBCs until they are completely infused. - Insert a larger gauge IV catheter and transfer the infusion to the new insertion site. - Discontinue the infusion and record the volume left in the blood bag. - Fully open the roller clamp on the infusion set and infuse the remaining PRBCs as rapidly as possible.

Discontinue the infusion and record the volume left in the blood bag.

The nurse must obtain a venous blood specimen for culture and sensitivity. Why does the nurse gather two separate collection bottles? - A large amount of blood is needed when testing a venous blood specimen for culture and sensitivity. - To collect extra blood that can be used for future blood tests as well. - Each collection bottle contains a different type of medium allowing for different types of bacteria growth. - To ensure the laboratory has an adequate amount of blood for testing.

Each collection bottle contains a different type of medium allowing for different types of bacteria growth.

The nurse has collected a blood sample from a client's central venous access device (CVAD). After removing the vacutainer, what should the nurse do next? - Flush the line with normal saline. - Flush the line with heparin. - Flush the line with sterile water. - Label the blood sample tube.

Flush the line with normal saline.

When changing the dressing of a central venous access device (CVAD), how should the nurse remove the old dressing? - Pull it up from the bottom to the top, applying pressure to the catheter with an antimicrobial swab. - Lift it distally, and then work proximally to the insertion site while stabilizing the catheter with the gloved finger of the nondominant hand. - Pull it up from the top to the bottom, applying pressure to the catheter with a gauze pad. - Lift it proximally, and then work distally while stabilizing the catheter with an antimicrobial swab.

Lift it distally, and then work proximally to the insertion site while stabilizing the catheter with the gloved finger of the nondominant hand.

A nurse is attempting to enlarge the veins of a client before venipuncture. Which techniques are appropriate? Select all that apply. - Lower the client's arm before applying the tourniquet. - Leave the tourniquet in place for up to 5 minutes before attempting venipuncture. - Ask the client to make a fist. - Lightly tap the skin over the vein. - Apply a warm compress to the limb before applying the tourniquet.

Lower the client's arm before applying the tourniquet. Ask the client to make a fist. Lightly tap the skin over the vein. Apply a warm compress to the limb before applying the tourniquet.

The nurse is preparing to initiate an infusion of packed red blood cells (PRBCs). While observing the information on the blood bag, it is essential to verify which information with another nurse? Select all that apply. - Name on the client's identification band - Number on the client's identification band - Client's vital signs - Patency of the client's venous access device - Client's room number

Name on the client's identification band Number on the client's identification band

A nurse is preparing to collect a venous blood specimen for culture and sensitivity from a client. The client has large, distended, highly visible veins in both arms. Which action should the nurse take when collecting blood from this client? - Stop the procedure and notify the client's health care provider. - Perform venipuncture on an arm without a tourniquet. - Apply warm compresses to the selected site on the arm 15 to 20 minutes before venipuncture. - Perform venipuncture using veins in the lower extremities.

Perform venipuncture on an arm without a tourniquet.

After removing the dressing of a client's central venous access device (CVAD), the nurse notes dried blood at the catheter insertion site. What is the next action by the nurse? - Put on clean gloves and cleanse the dried blood using a sterile antimicrobial wipe in a circular motion beginning at the insertion site and working outward. - Put on sterile gloves and cleanse the dried blood using a sterile antimicrobial wipe in a circular motion beginning at insertion site and working outward. - Put on sterile gloves and use a gauze pad to cleanse the dried blood using a circular motion beginning from the outside and working to the insertion site. - Put on clean gloves and cleanse the site using a chlorhexidine swab in a back and forth motion for 30 seconds.

Put on sterile gloves and cleanse the dried blood using a sterile antimicrobial wipe in a circular motion beginning at insertion site and working outward.

When the nurse is drawing a blood sample from a client's central venous access device (CVAD), the blood stops flowing after the collection tube has been placed. The nurse removes the tube and flushes the lumen with 5 mL of saline solution. What is the next action by the nurse? - Notify the health care provider. - Redraw the waste sample. - Attempt to collect the blood sample. - Flush with heparin.

Redraw the waste sample.

A nurse is administering a blood transfusion to a client. After 15 minutes, the client reports difficulty breathing. What is the first action by the nurse? - Notify the health care provider of the client's response. - Stop the transfusion and infuse normal saline using the blood tubing. - Check the client's vital signs. - Stop the transfusion and infuse normal saline using a new administration set.

Stop the transfusion and infuse normal saline using a new administration set.

The nurse is observing an unlicensed assistive personnel (UAP) drawing a blood sample from a client's central venous access device (CVAD). After the collection tube has been placed, the blood stops flowing. Which action by the UAP would require the nurse to intervene? - The UAP asks the client to raise the arm and cough. - The UAP flushes the lumen with 5 mL of sterile water. - The UAP replaces the specimen tube. - The UAP clamps the tubing and removes the tube and the vacutainer.

The UAP flushes the lumen with 5 mL of sterile water.

Which finding best indicates to the nurse that the client has a therapeutic outcome from a blood transfusion? - The client is free of chills, fever, and shortness of breath. - The client's face exhibits a normal skin tone and color. - The client's blood pressure increases to 90/48 mm Hg. - The client has a steady gait while ambulating to void.

The client has a steady gait while ambulating to void.

The nurse is collecting a blood sample from a client's central venous access device (CVAD) and notices that the flow stops when drawing the blood. What should the nurse do first? - Push down on the access needle. - Make sure the tubing is clamped. - Try a new specimen tube. - Raise the head of the bed.

Try a new specimen tube.

A nurse needs to obtain blood samples for lab studies to check the electrolyte levels for a client who has a multilumen non-tunneled percutaneous central venous catheter in place. The client is receiving intravenous (IV) fluids through the central venous access device (CVAD). What should be the nurse's first step in this procedure? - Turn off the flow of fluids to the CVAD. - Place the CVAD dial on "hold." - Increase the flow of fluids to the CVAD. - Flush the CVAD with normal saline.

Turn off the flow of fluids to the CVAD.

A nurse needs to obtain a venous blood sample from a term neonate. On the basis of recent research, which is the method of choice for collecting this client's sample? - Venipuncture with standard needle - Heel lance - Finger lancet - Venipuncture with butterfly needle

Venipuncture with butterfly needle

The nurse turns off an intravenous (IV) infusion and waits for 1 minute before obtaining a blood sample from the client's central venous access device (CVAD). For what client would this sequence of actions be appropriate? - a client receiving total parenteral nutrition (TPN) - a client receiving a solution that alters laboratory results - a client receiving heparin - a client receiving a standard IV solution

a client receiving a standard IV solution

The nurse is preparing to change the dressing for a client with a peripherally inserted central catheter (PICC). At what point would the nurse assess the insertion site? - when applying the skin protectant - after putting on clean gloves - as the site is being cleaned - after removing the old dressing

after putting on clean gloves

A nurse is preparing to draw a blood sample from a central venous access device (CVAD) that has more than one lumen. Which lumen is most appropriate for the nurse to use to take the sample? - longest - proximal - shortest - distal

distal

The nurse is caring for a client who has a peripherally inserted central catheter (PICC) in place to receive antibiotics. As the nurse prepares to change the dressing of the PICC, how should the nurse position the client? - sitting upright, with the arm flexed at the elbow below heart level - lying flat, with the arm extended from the body above heart level - sitting upright, with the arm extended from the body over the head - lying flat, with the arm extended from the body below heart level

lying flat, with the arm extended from the body below heart level