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:
Hemophilia is a genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This condition is not caused by shaking a blood collection tube; it is an inherited disorder typically caused by a mutation in one of the clotting factor genes.
Choice B Reason:
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually resulting from a loss of plasma. While this can occur due to various reasons, such as dehydration, it is not caused by shaking a blood collection tube. Shaking a tube does not change the ratio of cells to plasma in the blood.
Choice C Reason:
Hemolysis is the rupture of red blood cells, which can occur when a blood sample is handled roughly, such as by excessive shaking. This can cause the cells to break open and release their contents into the plasma, which can interfere with laboratory tests and lead to inaccurate results.
Choice D Reason:
Hemostasis is the process by which the body stops bleeding, which involves the clotting of blood. This process is not caused by shaking a blood collection tube. Hemostasis is a complex process that involves blood vessels, platelets, and clotting factors.
Correct Answer is A
Explanation
Choice A Reason:
Anchoring a vein is a technique used to stabilize the vein during venipuncture to prevent it from rolling. The recommended practice is to anchor the vein 1 to 2 inches below the puncture site. This is done by applying gentle traction on the skin downward with the thumb, which helps to stabilize the vein and facilitate the insertion of the needle.
Choice B Reason:
Anchoring 1 to 2 inches above the puncture site is not the standard practice. This position would not provide the necessary tension on the vein to prevent it from rolling and could make the venipuncture more difficult.
Choice C Reason:
Anchoring 2 inches left of the puncture site does not provide the correct angle or tension for stabilizing the vein for a venipuncture and is not a recommended technique.
Choice D Reason:
Anchoring 1 inch right of the puncture site is also not a recommended practice. Similar to anchoring to the left, this does not provide the proper stabilization needed for a successful venipuncture.
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