According to the CLSI standard, a phlebotomist must attempt to locate which of the following veins on both arms before considering other veins?
Median cubital vein
Basilic vein
Cephalic vein
Veins on the underside of the wrist
The Correct Answer is A
Choice A Reason:
The median cubital vein is often the first choice for venipuncture due to its size and accessibility. It is located in the antecubital fossa and is usually well anchored by surrounding tissues, which makes it less likely to roll during needle insertion. This vein is also less painful for patients when punctured due to its location and the type of surrounding tissue.
Choice B Reason:
The basilic vein is another option for venipuncture, but it is not typically the first choice. It is located on the medial aspect (inner side) of the arm and is more prone to rolling and injury because it is not as well anchored as the median cubital vein. Additionally, the basilic vein is located near nerves and arteries, which increases the risk of complications during venipuncture.
Choice C Reason:
The cephalic vein runs along the lateral aspect (outer side) of the arm and can be used for venipuncture. However, it is often more difficult to locate and has a tendency to roll, which can make venipuncture more challenging. It is usually considered after the median cubital vein.
Choice D Reason:
Veins on the underside of the wrist should generally be avoided for routine venipuncture because they are often smaller, can be more painful due to the proximity to nerves and tendons, and have a higher risk of complications. These veins are considered only when other sites are not available or are unsuitable for venipuncture.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Septicemia, also known as sepsis, is a serious bloodstream infection that can be life-threatening. It is not a disorder that is screened for at birth because it is not a congenital condition but rather an infection that can occur at any time when bacteria enter the bloodstream.
Choice B reason:
Bacteremia refers to the presence of bacteria in the bloodstream and, like septicemia, is not a congenital disorder. It is not typically screened for at birth as it is an acquired condition that can occur after exposure to bacteria.
Choice C reason:
Phenylketonuria (PKU) is a genetic disorder that results in an inability to metabolize the amino acid phenylalanine. Untreated, PKU can lead to intellectual disability, seizures, and other serious health problems. Newborn screening for PKU is required in every state in the U.S. because early detection and dietary treatment can prevent the severe consequences of the disorder.
Choice D reason:
Proteinuria is the presence of abnormal amounts of protein in the urine, which can be a sign of kidney disease. It is not a condition that is screened for at birth as part of the standard newborn screening panel.
Correct Answer is C
Explanation
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.

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