A patient has bilateral scarring on their forearms from past burn injuries and needs a venipuncture procedure. Which of the following veins should the phlebotomist use for the venipuncture draw?

Choice A Reason:
Signing a release for laboratory results is a form of expressed consent, not implied consent. Expressed consent is given explicitly, either orally or in writing, and is clearly and unmistakably communicated. It involves a clear action of agreement to the specific procedure or intervention proposed.

Choice B Reason:
Signing a document of agreement for a research study is also an example of expressed consent. The patient is actively agreeing to participate in the study, which is a direct and informed action. This type of consent is necessary for research studies to ensure that participants are fully aware of the study's nature and any potential risks involved.

Choice C Reason:
Implied consent occurs when a patient's actions suggest consent without verbal or written confirmation. Offering an arm to a phlebotomist is a non-verbal communication that implies the patient is willing to have their blood drawn. This is a common practice in medical settings where the action of presenting an arm indicates readiness for the procedure.

Choice D Reason:
A family member nodding for a phlebotomist to proceed does not constitute the patient's implied consent. Consent must come directly from the patient unless they are unable to provide it, in which case a legal surrogate may give consent on their behalf. The nod of a family member cannot be assumed as the patient's consent.

Choice A Reason:
Occult blood detection is a test that a phlebotomist is allowed to perform according to CLIA regulations. This test is typically used to detect hidden blood in the stool, which can be an early sign of colorectal cancer or other digestive system diseases. It is considered a waived test under CLIA, meaning it is simple and carries a low risk for an incorrect result.

Choice B Reason:
Flow cytometry is a complex test that requires specialized training and equipment. It is used to analyze the physical and chemical characteristics of particles in a fluid as they pass through at least one laser. Phlebotomists are not typically trained to perform this type of analysis, as it falls under the category of high complexity testing.

Choice C Reason:
Genetic molecular tests are used to detect specific sequences in DNA or RNA that may or may not lead to disease. These tests are complex and require specialized knowledge and equipment. They are not within the scope of practice for phlebotomists, who are trained primarily in blood collection.

Choice D Reason:
Electrophoresis is a laboratory technique used to separate DNA, RNA, or protein molecules based on their size and electrical charge. This type of test is also complex and requires specialized training and equipment, which is beyond the scope of a phlebotomist's duties.