A phlebotomist is collecting a urine drug screen from a Department of Transportation employee. The phlebotomist should take the specimen temperature at which of the following times following collection?
Before 4 minutes.
At 5 minutes.
At 15 minutes.
After 30 minutes.
The Correct Answer is A
Choice A Reason:
Taking the specimen temperature before 4 minutes is the correct procedure according to the Department of Transportation (DOT) guidelines. The DOT Rule 49 CFR Part 40 Section 40.65 states that the temperature of the specimen must be checked no later than four minutes after the employee has given the specimen. The acceptable temperature range is 32–38 °C/90–100 °F, which helps to verify the validity of the specimen.
Choice B Reason:
Taking the specimen temperature at 5 minutes is not within the DOT guidelines. The temperature must be taken before 4 minutes have passed to ensure the specimen's integrity and to comply with the regulatory requirements.
Choice C Reason:
At 15 minutes, the temperature check would be too late. The DOT guidelines specify that the temperature should be checked no later than four minutes after collection to ensure the specimen has not been tampered with and is within the acceptable temperature range.
Choice D Reason:
After 30 minutes, the temperature of the urine specimen would not reflect the body temperature at the time of collection, which is necessary for the validity of the test. This delay could allow for the temperature to fall outside of the acceptable range, potentially invalidating the specimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Simply observing the site to see if the hematoma worsens is not an appropriate response. While monitoring the development of a hematoma is part of the process, it is not a proactive measure to address the immediate issue. The phlebotomist must take action to prevent further injury or complication.
Choice B reason:
Asking the patient to apply pressure may be part of the post-venipuncture care, especially after the needle has been removed, to aid in stopping any bleeding. However, this does not address the immediate concern of a developing hematoma during the draw.
Choice C reason:
Releasing the tourniquet and stopping the draw is the correct action to take when a hematoma is observed. This response is in line with the standard procedure for when a complication arises during venipuncture. Stopping the draw helps prevent further blood from pooling and exacerbating the hematoma.
Choice D reason:
While calling for a nurse and assessing the patient's condition is important, especially if the phlebotomist needs assistance or the patient shows signs of distress, it should not be the first action taken. The immediate response should be to address the hematoma by stopping the draw.
Correct Answer is A
Explanation
Choice A Reason:
Asking "When was your last dose of lithium?" is crucial for therapeutic drug monitoring (TDM). TDM is used to tailor dosages and maintain therapeutic levels in a patient’s bloodstream, especially for drugs with narrow therapeutic indices like lithium. The timing of the last dose can significantly affect blood levels, and knowing this information helps in interpreting the results accurately.
Choice B Reason:
While knowing the fasting status of a patient may be relevant for certain tests, it is not typically critical for TDM unless the medication being monitored is affected by food intake. Lithium levels are not significantly influenced by fasting, so this question is less relevant than knowing the timing of the last dose.
Choice C Reason:
Inquiring about the last alcoholic beverage is important if alcohol could interfere with the medication's metabolism or the test's accuracy. However, for lithium TDM, alcohol consumption is not as directly relevant as the timing of the last dose. Alcohol does not typically alter lithium levels unless it affects the patient's hydration status.
Choice D Reason:
Asking if the patient has finished drinking the glucose solution would be pertinent if conducting a glucose tolerance test. However, this is not relevant for TDM of lithium, as the glucose solution does not interfere with lithium levels or the TDM process.
In conclusion, for therapeutic drug monitoring, particularly for lithium, the most critical question is regarding the timing of the last dose. This information is essential to ensure that the blood levels reflect the peak or trough concentration, depending on what is being measured, and to avoid misinterpretation that could lead to inappropriate dosing adjustments.
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