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 B
Explanation
Choice A reason:
A hair cap is used to prevent contamination from the hair, but it is not specifically designed to protect against body fluid splashes. While it is a part of personal protective equipment (PPE), it does not provide coverage for the areas most likely to be exposed to splashes during phlebotomy procedures.
Choice B reason:
A gown is the appropriate choice for protection against body fluid splashes. It covers a significant portion of the body and is designed to prevent fluids from reaching the phlebotomist's skin or undergarments, which is essential when there is a risk of splashes during procedures like venipuncture.
Choice C reason:
Shoe covers protect the feet from contamination, but they are not typically necessary for phlebotomy unless there is a significant risk of large fluid spills on the floor. They are more commonly used in operating rooms or during the cleaning of large spills.
Choice D reason:
Sterile gloves are a standard requirement for phlebotomy to maintain aseptic technique and prevent contamination. However, gloves alone do not provide sufficient protection against body fluid splashes that may reach other parts of the body.
Correct Answer is A
Explanation
Choice A Reason:
Contacting the physician by paging or calling right away is the most appropriate action when critical values are confirmed on a laboratory test. Critical values are defined as those that indicate the patient is in danger of death unless treatment is initiated immediately. Immediate notification of the responsible licensed caregiver is required so that appropriate clinical action can be taken for the patient. This is a standard procedure compliant with CLIA regulation 493.1109(f) and is essential for patient safety.
Choice B Reason:
Leaving a message at the physician's office number is not an adequate response to confirmed critical values. Messages can be overlooked or not checked until the next business day, which could delay necessary urgent medical interventions.
Choice C Reason:
Calling the physician's office on the next business day is not acceptable when dealing with critical values. The urgency of critical results requires immediate action, and waiting until the next business day could result in significant harm or death to the patient.
Choice D Reason:
Faxing the results to the physician's office with a stat fax cover is not sufficient for immediate communication of critical values. While the fax may indicate urgency, there is no guarantee that the fax will be seen immediately by the physician or their staff. Direct communication through paging or calling ensures that the critical information is relayed without delay.
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