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 D
Explanation
Choice A reason:
Collecting stool directly into a sterile container is not related to providing a sputum specimen. Stool samples are collected for different types of tests, such as fecal occult blood tests or microbiological cultures, and are not used for respiratory assessments.
Choice B reason:
Discarding the first urine of the day and collecting for 24 hours is a procedure for a 24-hour urine collection test, which is used to assess kidney function and other conditions. This process is unrelated to sputum specimen collection, which is used to evaluate respiratory infections or conditions.
Choice C reason:
Aggressively swabbing the inside of the cheek is a method used to collect cells for DNA testing or to check for oral infections. This action does not pertain to sputum collection, which requires a sample from the lower respiratory tract.
Choice D reason:
Taking a deep breath and then expectorating (coughing up and spitting out) is the correct method for providing a sputum specimen. This technique ensures that the sputum comes from deep within the lungs, which is necessary for accurate analysis of respiratory pathogens or cells.
Correct Answer is C
Explanation
Choice A Reason:
Notifying the provider about the error is an important step, but it does not correct the error in the patient's chart. Communication with the provider ensures that they are aware of the mistake and can make informed decisions regarding patient care. However, the physical correction of the documentation is also necessary to maintain accurate medical records.
Choice B Reason:
Asking an administrator to erase the error is not a recommended practice. Erasing or using correction fluid can make the chart appear tampered with, which can have legal implications. It is essential that the original entry remains visible to preserve the integrity of the medical record.
Choice C Reason:
Striking a line through the error and initialing is the correct method for correcting a written error in a patient's chart¹². This approach allows the original entry to remain legible, which is crucial for legal and clinical reasons. It also shows that the correction was made by an authorized individual, as the initials indicate who made the change.
Choice D Reason:
Erasing the error and entering the correct information is not an acceptable practice for the same reasons as choice B. It is important not to remove or conceal the original entry, as this could be considered falsifying medical records.
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