A phlebotomist is planning to collect a specimen to measure a patient's serum cortisol level. Which of the following factors should the phlebotomist consider?
Body temperature
Time of day
Alcohol consumption
Prandial status
The Correct Answer is B
Choice A Reason:
Body temperature does not significantly affect serum cortisol levels and is not a factor that needs to be considered when planning to collect a cortisol specimen. Cortisol levels are regulated by the hypothalamic-pituitary-adrenal axis and not by body temperature.
Choice B Reason:
Time of day is a critical factor to consider when collecting a specimen for serum cortisol level measurement. Cortisol levels follow a diurnal pattern, peaking in the early morning hours and declining throughout the day, with the lowest levels typically occurring around midnight¹². This variation is known as the cortisol awakening response (CAR) and is important for accurately interpreting the results of the test.
Choice C Reason:
Alcohol consumption can affect cortisol levels; however, it is not typically a factor that a phlebotomist needs to consider immediately before specimen collection unless the patient is under the influence at the time of the test. Chronic alcohol use can lead to alterations in cortisol levels, but this is more of a consideration for the healthcare provider interpreting the results rather than the phlebotomist collecting the specimen.
Choice D Reason:
Prandial status, or the fed or fasting state of the patient, can influence cortisol levels, but it is not as significant a factor as the time of day. Cortisol levels can be slightly higher after eating, but this effect is generally considered minimal. The primary concern for prandial status would be if the cortisol test is being conducted alongside other tests that require fasting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
A patient's room number is not considered a unique identifier by the Joint Commission standards. Room numbers can change if patients are moved, and they do not reliably identify an individual.
Choice B Reason:
A patient's bed label is also not a unique identifier. Bed labels can be switched, and similar to room numbers, they are not specific to the individual patient.
Choice C Reason:
A patient's inpatient chart typically contains multiple unique identifiers, such as the patient's name, an assigned identification number, date of birth, or other person-specific identifiers. These are considered acceptable by the Joint Commission for verifying patient identity, ensuring that the service or treatment is intended for that individual.
Choice D Reason:
Patient's verbal confirmation alone is not sufficient for establishing correct inpatient identification. While it can be used as one method of identification, it should be supplemented with another identifier to meet the Joint Commission's requirement of using at least two patient identifiers.
Correct Answer is C
Explanation
Choice A Reason:
CLIA, or the Clinical Laboratory Improvement Amendments, sets standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results. While CLIA provides a framework for laboratory operation, it does not offer specific guidelines for chemical spill cleanup.
Choice B Reason:
OSHA, or the Occupational Safety and Health Administration, provides regulations to ensure worker safety, including protocols for handling hazardous materials. However, OSHA itself does not provide the specific cleanup procedures; instead, it requires workplaces to follow certain safety practices.
Choice C Reason:
SDS, or Safety Data Sheets, provide detailed information on chemicals, including their properties, health hazards, protective measures, and safety precautions, including spill response and cleanup procedures. In the event of a chemical spill, the SDS contains the most direct instructions for safe and effective cleanup, making it the primary reference for a phlebotomist in this situation.
Choice D Reason:
The CDC, or Centers for Disease Control and Prevention, focuses on public health and disease prevention. While the CDC provides guidelines for infection control and laboratory safety, it is not the primary resource for chemical spill cleanup procedures.
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