During a venipuncture, the needle is in the vein and blood flow is established. When the second tube is attached, blood flow stops. Which of the following actions should the phlebotomist take?
Withdraw the needle completely.
Rotate the bevel of the needle.
Increase tourniquet pressure.
Activate a new evacuated tube.
The Correct Answer is D
Choice A Reason:
Withdrawing the needle completely would be an incorrect action because it would end the procedure prematurely and require a new venipuncture, causing unnecessary discomfort to the patient. It should only be done if the venipuncture has been completed or if there is a need to stop due to a complication.
Choice B Reason:
Rotating the bevel of the needle could potentially reposition the needle for better blood flow if it has become occluded or is not properly aligned with the vein. However, this action should be done with caution to avoid causing injury to the vein or discomfort to the patient.
Choice C Reason:
Increasing tourniquet pressure is not advisable once blood flow has been established, as it could cause damage to the vein or hemolysis of the blood sample. The tourniquet should be released once the blood starts flowing into the first tube to avoid these issues.
Choice D Reason:
Activating a new evacuated tube is the correct action to take when blood flow stops upon attaching a second tube. This could indicate a problem with the vacuum in the tube rather than with the needle or the venipuncture site. Trying a new tube can resolve the issue without needing to adjust the needle or the patient's position.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Holding the two slides at a 90-degree angle is not the correct technique for performing a blood smear. This angle is too steep and would not allow the blood to spread thinly across the slide, which is necessary for creating a quality smear that can be examined under a microscope.
Choice B reason:
Allowing the blood drop to clot slightly before performing the smear is not advisable. Clotting can interfere with the spread of the blood and the formation of a monolayer, which is essential for accurate microscopic examination. The blood should be fresh and anticoagulated to prevent clotting.
Choice C reason:
Holding the slides at a 30-degree angle is the correct technique for performing a blood smear. This angle allows the spreader slide to push the blood drop smoothly across the patient slide, creating a thin, even layer of blood that is ideal for microscopic analysis. The angle, speed, and pressure must be consistent to achieve a quality smear.
Choice D reason:
Allowing the blood drop to clot completely before performing the smear would make it impossible to create a smear. Clotted blood cannot be spread into a thin layer, which is necessary for microscopic examination of the blood cells.
Correct Answer is A
Explanation
Choice A Reason:
Occult blood detection is a test that a phlebotomist is allowed to perform according to CLIA regulations. This test is typically used to detect hidden blood in the stool, which can be an early sign of colorectal cancer or other digestive system diseases. It is considered a waived test under CLIA, meaning it is simple and carries a low risk for an incorrect result.
Choice B Reason:
Flow cytometry is a complex test that requires specialized training and equipment. It is used to analyze the physical and chemical characteristics of particles in a fluid as they pass through at least one laser. Phlebotomists are not typically trained to perform this type of analysis, as it falls under the category of high complexity testing.
Choice C Reason:
Genetic molecular tests are used to detect specific sequences in DNA or RNA that may or may not lead to disease. These tests are complex and require specialized knowledge and equipment. They are not within the scope of practice for phlebotomists, who are trained primarily in blood collection.
Choice D Reason:
Electrophoresis is a laboratory technique used to separate DNA, RNA, or protein molecules based on their size and electrical charge. This type of test is also complex and requires specialized training and equipment, which is beyond the scope of a phlebotomist's duties.
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