A phlebotomist is preparing to perform a venipuncture. Which of the following needle positions should the phlebotomist use?
Bevel down at a 30° angle
Bevel up at a 45° angle
Bevel up at a 30° angle
Bevel down at a 45° angle
The Correct Answer is C
Choice A reason:
Having the bevel down at a 30° angle is not the correct needle position for venipuncture. The bevel of the needle should be facing up to allow for a smoother insertion and to minimize the risk of damaging the vein or causing discomfort to the patient.
Choice B reason:
Positioning the bevel up at a 45° angle is not recommended for venipuncture as this angle is too steep and could lead to the needle penetrating through the vein, potentially causing a hematoma or other complications.
Choice C reason:
The bevel up at a 30° angle is the correct position for venipuncture. This position allows the phlebotomist to insert the needle with the bevel facing upwards, which is the sharpest part of the needle, ensuring a clean entry into the vein. The 30° angle is shallow enough to enter the vein without going through it and causing injury.
Choice D reason:
A bevel down at a 45° angle is incorrect for the same reasons as choice B. Additionally, with the bevel down, the non-beveled side, which is duller, would make the initial contact with the skin, potentially causing more pain and making it more difficult to penetrate the vein.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Reporting the exposure to the supervisor is the immediate and required action after experiencing a needlestick injury. The supervisor will then guide the phlebotomist through the institution's post-exposure protocol, which includes immediate care of the wound, evaluation of the exposure, and initiation of post-exposure prophylaxis (PEP) if necessary. This step is crucial to ensure that the risk of HIV transmission is minimized and that the phlebotomist receives appropriate medical attention and follow-up.
Choice B reason:
Reporting the exposure to the Centers for Disease Control and Prevention (CDC) is not the immediate action required. The CDC provides guidelines and recommendations for handling such incidents, but the initial report and response are managed at the healthcare facility level. The CDC may be involved in the tracking of such incidents on a larger scale or providing statistical data, but they are not the first point of contact.
Choice C reason:
Sending the patient for further sexually transmitted infection (STI) testing is not an immediate action required following a needlestick injury. The patient's HIV status is already known, and the focus should be on the treatment and protection of the healthcare worker who experienced the needlestick. Any additional testing of the patient would be unrelated to the immediate management of the injury.
Choice D reason:
Saving the collection device for future evaluation is not a standard procedure. While the device may be retained as part of the incident investigation to determine how the injury occurred and to improve safety measures, the immediate concern is the treatment of the injured healthcare worker. The device itself does not play a role in the post-exposure management of the worker.
Correct Answer is D
Explanation
Choice A reason:
The light green tube typically contains lithium heparin and is used for plasma determinations in chemistry. It is not suitable for coagulation studies, such as PT, because heparin is an anticoagulant that would interfere with the test results.
Choice B reason:
The lavender tube contains EDTA, which is an anticoagulant that binds calcium. While it is commonly used for complete blood counts (CBC) and other hematology tests, it is not appropriate for coagulation studies because the binding of calcium would affect the clotting process required for a PT test.
Choice C reason:
The royal blue tube can come with different additives or be additive-free, depending on the color of the closure. It is primarily used for trace element testing, toxicology, and nutrient determinations. The additives in a royal blue tube could potentially contaminate the sample and interfere with the PT test.
Choice D reason:
The light blue tube contains sodium citrate, which is the appropriate anticoagulant for coagulation studies like PT. Sodium citrate works by binding calcium in the blood, preventing clotting. The PT test measures the time it takes for a clot to form after re-calcification, making the light blue tube the correct choice for this test.
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