A phlebotomist should identify that a blood spot collection for inborn errors of metabolism requires which of the following?
The newborn must be at least 3 days old.
The circles on the filter paper must be at least half filled.
The first drop of blood immediately following the puncture must be included.
The specimen must be completely dried before the test can be processed.
The Correct Answer is D
Choice A Reason:
The age of the newborn is important for certain metabolic screenings, as some metabolites may not be present or at measurable levels immediately after birth. However, the requirement for the newborn to be at least 3 days old is not a standard for all blood spot collections for inborn errors of metabolism (IEM). Some screenings are performed within 24 to 48 hours after birth.
Choice B Reason:
While it is important that the circles on the filter paper are adequately filled to ensure there is enough blood for the test, the requirement for them to be at least half filled is not specified in the guidelines. The focus is usually on ensuring the blood spot is of the right size and properly saturated through the filter paper.
Choice C Reason:
The inclusion of the first drop of blood is not typically a requirement. In fact, the first drop is often wiped away to avoid contamination with tissue fluids that could affect the test results. Subsequent drops are used to fill the circles on the filter paper.
Choice D Reason:
The specimen must be completely dried before the test can be processed to prevent degradation or hemolysis of the blood sample. This is a critical step in the preparation of the sample for accurate testing of IEM. The drying process helps preserve the integrity of the metabolites to be analyzed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
When a patient is under "Contact Precautions," it is recommended that healthcare workers don a gown upon entering the patient's room. This is to prevent the spread of infection through contact with the patient or their environment. The gown should be removed before leaving the room to avoid contaminating other areas.
Choice B Reason:
While a face shield may be necessary for certain procedures, it is not specifically required for "Contact Precautions." The primary concern with contact precautions is preventing the transmission of infections through touch, not through droplets, which is what a face shield would protect against.
Choice C Reason:
Donning a mask is not a standard requirement for "Contact Precautions" unless there is a risk of droplet transmission. In this scenario, the precautions are specifically for contact, and therefore, a mask alone would not be sufficient.
Choice D Reason:
Gloves should be donned before any potential contact with the patient or their immediate environment, not just after cleaning and evaluating the venipuncture site. Gloves are a critical component of PPE when dealing with patients under "Contact Precautions."
Correct Answer is A
Explanation
Choice A reason:
The lateral section of the plantar heel is the recommended site for capillary blood collection in infants, particularly those under 6 months of age. This area is preferred because it is sufficiently vascularized for blood collection and poses less risk of injury to bones and nerves compared to other areas.
Choice B reason:
The central area of the heel is not recommended for capillary blood collection in infants due to the higher risk of injury to the calcaneus (heel bone) and potential for calcaneal osteomyelitis, an infection of the bone.
Choice C reason:
The posterior curvature of the heel is also not an appropriate site for capillary blood collection in infants. This area has a higher likelihood of causing pain and injury, as well as being less accessible for a proper puncture technique.
Choice D reason:
The palmer surface of the distal phalanx (fingertip) is not a recommended site for capillary blood collection in infants under 1 year of age. The fingertips of infants are small and more prone to injury, and the procedure may be more painful compared to a heel stick.
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