A phlebotomist is preparing to perform venipuncture on a patient who had a right-sided mastectomy. Which of the following is the correct site to perform the collection?
Left antecubital
Right cephalic
Left femoral artery
Right basilic
The Correct Answer is A
Choice A reason:
The left antecubital area is the correct site to perform venipuncture on a patient who has had a right-sided mastectomy. It is recommended to avoid the side of the mastectomy due to the risk of lymphedema and other complications associated with the removal of lymph nodes during the surgery. The left antecubital fossa, which is the area in front of the elbow, is a common site for venipuncture and is generally safe for use when the right side cannot be used.
Choice B reason:
The right cephalic vein should be avoided in a patient with a right-sided mastectomy. Venipuncture on the same side as the mastectomy can increase the risk of complications, including lymphedema, which is a condition characterized by swelling due to lymph fluid accumulation. Therefore, the right cephalic vein is not an appropriate choice.
Choice C reason:
The left femoral artery is not a venipuncture site; it is an arterial site. Venipuncture refers to accessing a vein, not an artery, for blood collection. Additionally, arterial puncture is a more invasive procedure typically reserved for arterial blood gas analysis and is not performed for routine venipuncture.
Choice D reason:
Similar to choice B, the right basilic vein should be avoided for venipuncture in a patient who has had a right-sided mastectomy. The basilic vein is located on the inner side of the arm and using it could pose the same risks as using the right cephalic vein, including the potential for lymphedema.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Blood for HIV testing does not typically require a chain of custody form. HIV testing is a confidential medical test, but the results are not usually used for legal purposes, which is when a chain of custody would be necessary.
Choice B Reason:
Sputum for tuberculosis testing also does not require a chain of custody form. While the test is critical for diagnosing tuberculosis, the results are used for medical diagnosis and treatment rather than legal proceedings.
Choice C Reason:
Blood for paternity testing requires a chain of custody form because the results can have legal implications, such as establishing paternity for child support or custody cases. The chain of custody ensures that the sample is properly handled and tracked from collection to analysis, preventing tampering or misidentification.
Choice D Reason:
A swab for chlamydia testing, like HIV testing, is a confidential medical test that does not usually require a chain of custody form. The results are used for medical purposes, such as diagnosis and treatment, rather than legal proceedings.
Correct Answer is A
Explanation
Choice A Reason:
The evacuated tube system is designed for the collection of multiple blood specimens using interchangeable tubes. This system utilizes a double-pointed needle, one end of which goes into the patient's vein and the other into a vacuum tube. As the blood is drawn, it automatically fills the tube until the vacuum is exhausted. The phlebotomist can then easily replace the filled tube with another without removing the needle from the patient's vein, allowing for multiple samples to be taken during a single venipuncture.
Choice B Reason:
The hypodermic needle and syringe system is typically used for manual blood draws when the evacuated tube system is not suitable, such as with small or fragile veins. This system does not use interchangeable tubes; instead, the blood is drawn into a syringe and then transferred into the appropriate tubes, which can be time-consuming and increase the risk of hemolysis or contamination.
Choice C Reason:
A winged infusion set, also known as a butterfly needle, is often used for patients with difficult veins. Like the hypodermic needle and syringe system, it does not inherently allow for the use of interchangeable multi-sample tubes. Blood is collected into a syringe or a single tube attached to the butterfly needle, and changing tubes usually requires a new puncture for each sample.
Choice D Reason:
The lancet microcollection system is used for capillary blood collection, typically from a fingerstick or heelstick. It is used for small volume samples and does not accommodate interchangeable multi-sample tubes. This method is commonly used for pediatric patients or when only a small amount of blood is needed.
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