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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Glucose and triglyceride levels are influenced by recent food intake, so it is essential to measure these levels after a period of fasting to obtain accurate results. Fasting ensures that the glucose measurement reflects the body's baseline glucose level without the influence of a recent meal, which is crucial for diagnosing and managing conditions like diabetes. Similarly, triglycerides, which are fats in the blood, can be elevated after eating, so a fasting sample gives a clear picture of the lipid profile for assessing cardiovascular risk.
Choice B reason:
While BUN (Blood Urea Nitrogen) levels can be affected by diet, fasting is not typically required for BUN or alkaline phosphatase tests. These tests are often part of a comprehensive metabolic panel that may or may not require fasting. However, fasting is not specifically necessary for accurate measurement of these two tests.
Choice C reason:
Creatinine and total protein levels are generally not affected by short-term dietary intake, so fasting is not required for these tests. Creatinine is a waste product from muscle metabolism and is used to evaluate kidney function, while total protein levels can indicate a variety of conditions including liver and kidney disorders, but they reflect the body's long-term nutritional status rather than immediate food intake.
Choice D reason:
Lactate dehydrogenase (LDH) and albumin tests do not require fasting. LDH is an enzyme found in almost all body tissues and is released into the bloodstream when tissues are damaged, so its levels are not dependent on food intake. Albumin is the most abundant protein in the blood and is produced by the liver; its levels are used to assess liver and kidney function, nutritional status, and other conditions, but fasting is not necessary for accurate measurement.
Correct Answer is B
Explanation
Choice A reason:
Wearing gloves is an important step in preventing the spread of infection, but it is not the first step. Gloves provide a barrier between the phlebotomist's hands and the patient, which can help prevent the transmission of pathogens. However, gloves can still become contaminated, and if hand hygiene is not performed before donning gloves, pathogens can be transmitted when gloves are changed or removed.
Choice B reason:
Hand hygiene is widely recognized as the single most important practice in preventing the spread of infections. It is the first line of defense against the transmission of infectious agents. Washing hands with antimicrobial soap and water mechanically removes pathogens, and the antimicrobial agents in the soap can kill or inhibit the growth of microorganisms. This step is crucial before any patient contact, especially before invasive procedures like venipuncture.
Choice C reason:
Applying antiseptic to the puncture sites prior to venipuncture is a critical step in the prevention of infection at the site of the blood draw. This practice is essential for eliminating skin flora that could potentially enter the bloodstream during venipuncture. However, this is not the first step, as effective hand hygiene should precede any patient contact or procedure.
Choice D reason:
Decontaminating equipment before use is a necessary step to ensure that no infectious agents are transmitted via medical instruments. This includes cleaning and sterilizing equipment that comes into direct contact with the patient. While this is a vital part of infection control, it follows hand hygiene in the sequence of steps a phlebotomist should take.
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